Medpace Respiratory Experts Share Highlights from ERS Congress 2026
In September 2026, Medpace respiratory experts attended the ERS Congress in Barcelona, Spain. As the world’s largest respiratory meeting, the ERS Congress brings together delegates from around the world to discuss enhancing the treatment and care of respiratory illness. ERS 2026 showcased a respiratory pipeline increasingly shaped by precision medicine, earlier intervention, and objective biomarkers. Across airway disease, interstitial lung disease (ILD), pulmonary hypertension associated with ILD (PH-ILD), and quantitative imaging, emerging data pointed beyond symptom control towards disease stability, remission, slower progression, and reduced healthcare burden.
Continue reading for 4 key insights from Medpace experts.
Airway Disease: Biologics Raise the Bar
Biologic therapies are reshaping the management of severe asthma and COPD by enabling more targeted treatment, longer dosing intervals, and a greater focus on clinical remission, disease stability, and reduced healthcare burden.
For example, depemokimab reduced exacerbations with twice-yearly dosing in the Phase III SWIFT-1 and SWIFT-2 trials, with longer-term outcomes assessed in AGILE. In VESTIGE, dupilumab reduced CT-measured mucus plugging and improved lung function, illustrating benefits beyond exacerbation prevention.
Other severe-asthma biologics, including mepolizumab, benralizumab, and tezepelumab, have contributed to increasing rates of symptom control, freedom from exacerbations, and reduced oral corticosteroid use, although continued monitoring remains important because some patients relapse or lose response.
In COPD, dupilumab and mepolizumab have shown benefit in selected patients with type 2 inflammation, while tozorakimab reduced moderate and severe exacerbations in the Phase III OBERON and TITANIA trials. Collectively, these studies support earlier biomarker-guided treatment and the development of longer-acting, phenotype-directed anti-inflammatory strategies.
Interstitial Lung Disease: A Broader Therapeutic Pipeline
The therapeutic landscape in pulmonary fibrosis is expanding beyond established antifibrotic treatment, with emerging therapies targeting lung-function decline, epithelial injury, and broader disease progression. For example, nerandomilast reduced FVC decline across IPF and progressive pulmonary fibrosis in the FIBRONEER-IPF and FIBRONEER-ILD trials, with particularly notable benefit in patients diagnosed within the previous year; reductions in KL-6 and SP-D also suggested effects on epithelial injury and fibrotic pathways. In the TETON-IPF studies, inhaled treprostinil provided an approximately 112 mL FVC benefit versus placebo at week 52, while a greater proportion of patients achieved improvements in DLCO. Further examples illustrate the increasing diversity of mechanisms and development strategies. The selective PDE4B inhibitor HSK44459 improved FVC at higher doses with a manageable safety profile, while the Phase III ALOFT-PPF study is evaluating admilparant, an oral LPA₁ antagonist, in a broad PPF population. Early translational findings also suggest that seralutinib combined with nintedanib may produce synergistic antifibrotic effects, supporting future combination strategies.
CT Scanning and AI: From Diagnostic Image to Digital Biomarker
AI-powered quantitative CT is transforming how ILD and pulmonary fibrosis are characterized. New approaches can objectively quantify fibrosis, ground-glass opacities, honeycombing, airways and pulmonary vessels—features that may be difficult to assess consistently through visual interpretation alone. Across prospective ILD cohorts, quantitative airway measurements emerged as strong predictors of survival, while quantitative pulmonary vascular measurements have shown potential prognostic value in idiopathic pulmonary fibrosis.
By reducing variability between readers and integrating imaging with biomarkers such as KL-6 and SP-D, quantitative CT may enable more reproducible risk stratification, earlier detection of progression, and more precise identification of patients at greatest risk of hospitalization or mortality. For clinical development, these tools could support patient enrichment, objective longitudinal monitoring, and more sensitive assessment of treatment response.
PH-ILD: Targeting the Vascular Component
PH-ILD, historically an area with limited treatment options, is gaining a more diverse therapeutic pipeline. In the Phase II PHOCUS study of 135 patients, inhaled mosliciguat achieved a robust and statistically significant reduction in pulmonary vascular resistance at week 16: approximately 51% versus a 7% increase with placebo. Secondary endpoints, including six-minute walk distance and NT-proBNP, also showed improvement in the treatment arms compared to placebo.
Other programs include novel treprostinil formulations, seralutinib, and vascular-targeted therapies. Preclinical results for NS-863, a highly selective oral PDGFR inhibitor, demonstrated improvements in pulmonary vascular remodeling, right ventricular hypertrophy, and survival in PAH and PH-ILD models, supporting progression into Phase II development. Together, these findings reinforce the concept that endothelial dysfunction, immune activation, fibrosis, and vascular remodeling are interconnected—and may be amenable to multi-pathway treatment strategies.
The direction of travel is clear: respiratory medicine is moving toward earlier intervention, biologically targeted therapy, and measurable disease modification. As imaging, biomarkers, and innovative trial designs become more closely integrated, developers will be better positioned to identify responsive populations, track meaningful change, and translate scientific advances into durable patient benefit.
Unable to connect with us during the ERS Congress? We welcome the opportunity to collaborate. Contact our respriatory experts to discuss how Medpace can support your upcoming clinical development plans.
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