The last 10 years has seen the introduction of multiple fixed dose combination products in asthma and chronic obstructive pulmonary disease (COPD), endotyping of patients for biologic options in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), the first disease-specific drugs for idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis interstitial lung disease (PPF-ILD) and novel modes of administration in pulmonary arterial hypertension (PAH).

In an increasingly crowded market, new entrants find themselves competing with established standards of care. At the same time, new clinical and real-world data keeps adding to the evidence on which current recommended treatment approaches are based, although sometimes dividing expert opinion.

In the future, real world evidence should continue to shape and challenge the expectations of physicians and patients for disease care and prognosis. Roles of biomarkers, new concepts such as ‘clinical remission’ in asthma, physician and patient education to help shorten time to diagnosis for rare respiratory conditions, and multi-modal treatment of respiratory disease will drive improvement in patient care and quality life.

The Respiratory portfolio of DSPs are designed to provide insight and evidence as to the impact of these changes as well as help form future thinking through mapping current treatment and management practices, understanding changing physician opinion and alignment with guidelines, and identifying areas of continued disease burden and unmet need. Importantly, they continue to provide evidence to support the wider medical community in understanding respiratory disease in real-world populations.

Eosinophilic diseases occur when eosinophils are found to be at above average levels in various parts of the body. At regular levels, eosinophils in the blood are useful in attacking potentially harmful substances such as an allergy-triggering food. However, when the body produces too many eosinophils, they can cause chronic inflammation resulting in tissue damage.

Some of the most prevalent diseases involve elevated levels of eosinophils in the oesophagus (EoE), stomach (EoG) or duodenum (EoD), while some patients experience multi organ damage as a result of their blood eosinophil count such as eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndromes (HES).

Eosinophilic diseases are often misdiagnosed because symptoms are shared with many other more common conditions, and there is a lack of approved medication to help physicians and patients manage these conditions effectively. The recent emergence of biologic therapies as potential new interventions are the most exciting ongoing development in the area of eosinophilic diseases.

Real-world data on the impact of eosinophilic diseases is limited, and DSPs in these therapeutic areas aim to address this evidence gap. Data collected from physicians treating these conditions and their patients’ experience will not only describe approaches to treatment, diagnostic journeys and patient profiles, but also the level of continued unmet need. Currently ARW have active DSPs for EoE, EGPA & HES and we aim to continue our research in other eosinophilic diseases in the future.