by Lynn M. Schnapp, MD, vice president of the American Thoracic Society
Dr. Schnapp is a tenured professor of medicine and division chief of Pulmonary, Critical Care, Allergy and Sleep Medicine at the Medical University of South Carolina (MUSC), in Charleston, SC.
@schnapplynn
One of the highlights of the year for me has always been attending the annual ATS International Conference. The meeting provides an outstanding blend of the latest clinical findings and cutting-edge research topics, tossed together with stellar networking opportunities with over 15,000 attendees. This year marked the completion of my first full year as a member of the ATS Executive Committee, which gave me a new perspective on this hallmark event for clinicians, researchers and allied professionals in pulmonary, critical care and sleep medicine.
The NEJM and JAMA sessions exemplify the new, cutting-edge research presented each year at the ATS international conference. While nintedanib and pirfenidone are FDA-approved treatments for IPF, clinicians have wondered whether these treatments would be effective for other interstitial lung diseases (ILD). The SENSCIS trial data presented at ATS 2019 showed for the first time that among patients with ILD associated with systemic sclerosis, the annual rate of decline in lung function was lower with nintedanib than with placebo after 52 weeks of treatment.
Another highly anticipated talk was the presentation of the results of the Reevaluation of Systemic Early Neuromuscular Blockade (ROSE) trial conducted by the NHLBI’s Prevention and Early Treatment of Acute Lung Injury (PETAL) network. Almost a decade ago, a multi-center ARDS clinical trial demonstrated that heavy sedation with 48 hours of continuous neuromuscular blockade was beneficial when compared to 48 hours of heavy sedation alone. Despite these encouraging results, early continuous neuromuscular blockade is not widely adopted in ARDS management and only weakly recommended in current guidelines, due to a number of uncertainties in the original study. The ROSE study was designed to address these uncertainties. With over 1000 patients enrolled, ROSE investigators found there was no difference in hospital mortality from any cause at 90 days between the intervention (neuromuscular blockade) group and control group. There were also no consistent differences in secondary outcomes including neuromuscular or long-term assessments. There was a significant increase in reported serious cardiovascular adverse events in the intervention group. The investigators concluded that among patients with moderate-to-severe ARDS there was no significant difference in mortality at 90 days between patients who received early and continuous neuromuscular blockade and those who were treated with a usual-care approach with lighter sedation targets.
This year’s Presidential Symposium celebrated the 50th Anniversary of the Lung Division of NHLBI and highlighted 50 years of progress in pulmonary science. The session started with an overview of the history of the Lung Division by Gary Gibbons, MD, the director of the NHLBI. Next up was Jeff Drazen, MD, editor of the NEJM, who discussed the evolution of asthma treatment, from clunky delivery systems of inhaled beta agonists, to today’s arsenal of monoclonal antibody therapeutics, artfully punctuated with a soundtrack of the songs of the times. Jeff Whitsett, MD, discussed the journey for babies born with Respiratory Distress Syndrome, which has gone from the leading cause of infant mortality to a rarely encountered disorder with the advent of surfactant therapy, non-invasive ventilation and other advances. MeiLan Han, MD, reviewed the evolution of our understanding of COPD pathogenesis, emphasizing the increasing recognition of COPD as a global health epidemic. Carolyn Calfee, MD, took us on a tour of the history of ARDS, from its first description by Ashbaugh and colleagues in 1967, to the brink of molecular phenotyping of ARDS today. The session ended with a sneak peek into the next 50 years of pulmonary science with video montages highlighting the research programs of 4 rising stars in pulmonary medicine.
ATS members and our colleagues in the field continue to express concern about youth smoking and a number of sessions examined the risks, among them: “Addicting A New Generation: Juuling, Vaping, Heat Not Burn, Flavorings, and the Evidence for Why We Should be Very Concerned.”
The Next Generation
The ATS international conference has always been and continues to be a welcoming place for early career professionals. I’ve personally found a tremendous amount of satisfaction in mentoring the next generation of leaders in the field, and ATS 2019 offered extensive opportunities for networking, and career development. The Early Career and PhD receptions were bustling with energy, and excitement. The ever-popular Resident Bootcamp for residents becoming new fellows and Fellows Track Symposium for fellows launching into their first faculty position provided hands-on learning, and an opportunity to get a headstart on their new roles.
The Diversity Luncheon and Women’s luncheon were both standing-room-only events, with moving testimonials from Marc Nivet, EdD, MBA of University of Texas Southwestern Medical Center, Dallas; Lorraine Ware, MD, of Vanderbilt University School of Medicine, Nashville, Tennessee; Julie Bastarache, MD, MPH, of Vanderbilt University Medical Center; and Monica Kraft, MD, the Elizbeth A. Rich, MD Awardee.
Finally, the plenary session featured photojournalist Ed Kashi, whose visuals created a powerful story of the human condition. It was impossible not to come away from those sessions without feeling awed and inspired.
I hope this piques your interest in the ATS conference. If you weren’t following our conference hashtag this year, tune into @atscommunity on twitter and Facebook to catch up on the conversation about all the hot topics and more at #ATS2019. And if you missed the conference but want access to the tremendous content delivered there, please visit the ATS Store.
Of course, if you care to avoid FOMO next year, make plans to join us at ATS 2020 in Philadelphia, home of the first medical school in the United States and the infamous Philly cheesesteak. I look forward to seeing you there!
