European Respiratory Society (ERS) Congress 2025 Review
Amsterdam, Netherlands | 27 September – 1 October 2025
The 2025 European Respiratory Society (ERS) Congress is one of the largest events on the respiratory medicine calendar. In this article our team of respiratory experts combine their most important takeaways relating to lung function diagnostics and their use in clinical trials.
The overarching themes of the meeting included advances in oscillometry, digital health adoption, and evolving trial designs in asthma, COPD, and interstitial lung disease (ILD).
Oscillometry and Airway Assessment
Oscillometry continued to gain prominence as a sensitive tool for evaluating small airway disease. New reference values published shortly before the meeting are being discussed to standardize cross-study comparisons1. Studies presented by Usmani, De Jongh, and Chow demonstrated the method’s reproducibility and sensitivity, particularly when standardized for breathing frequency. In asthma and ILD, spectral and intra-breath oscillometry parameters correlated with FVC decline, reinforcing its role as a potential secondary endpoint in future trials.
Asthma: Biomarkers and Digital Integration
Asthma remains a rapidly evolving therapeutic area, with six approved biologics (omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab) now integrated into practice. Fractional exhaled nitric oxide (FeNO) continues to serve as a key marker for drug selection and treatment monitoring. The SMART study2 underscored the influence of timing in spirometry, while the AJAX3 trial validated the feasibility of remote, video-coached spirometry, important for decentralized clinical trial models.
FeNO ≥50 ppb was again identified as a strong diagnostic and prognostic marker. Machine learning approaches for pulmonary function interpretation, developed by Chow and Wu in Toronto, suggest future opportunities for automated, open-source analytics within trial software platforms.
COPD: Rethinking Endpoints and Access
Several COPD sessions explored the challenges of biologic therapies and trial design. The Phase III ARNASA study4 (astegolimab) failed to meet its primary endpoint, prompting calls to extend observation periods beyond 52 weeks. Oscillometry data presented by Abdo linked small-airway dysfunction to cardiovascular comorbidities in pre-COPD individuals, highlighting an emerging area for early intervention.
The POLARIS project demonstrated how workflow-assistive software can streamline COPD diagnostic pathways, reducing waiting lists and time to inhaler initiation—particularly benefiting socioeconomically disadvantaged populations.
Interstitial Lung Disease and Pulmonary Fibrosis
Interest in ILD continues to expand, with numerous phase II and III studies targeting fibrosis-related pathways. The approval of nerandomilast (Jascayd, Boehringer Ingelheim) - the first new IPF/PPF therapy in over a decade, marking a significant milestone. Slowing FVC decline remains the regulatory gold standard, though clinicians advocated for the inclusion of quality of life endpoints. Oscillometry parameters such as inspiratory Xrs5 showed strong correlation with FVC changes, suggesting potential as non-invasive progression markers.
Cough Research and Clinical Pathways
Cough research maintained strong representation, with multiple collaborations presented by Vitalograph and academic partners. The integration of cough monitoring into standard care pathways was a recurring theme, with emphasis on rapid data analysis and real-time reporting. The Merck industry session highlighted a 5–10% prevalence of chronic cough across Europe and the emergence of new diagnostic frameworks. Vitalograph’s collaborations continue to position the company at the forefront of objective cough analytics.
Digital Health and Implementation Science
Digital transformation in respiratory care remains uneven. While approximately 75% of the EU workforce is projected to use digital tools by 2030, current competency among healthcare professionals and patients remains limited. The RE-AIM/PRISM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) was proposed as a structured approach for evaluating digital respiratory platforms.
Conclusion
ERS 2025 underscored a paradigm shift toward precision diagnostics and digital integration in respiratory diagnostics. For organizations such as Vitalograph, aligning technological innovation with emerging research priorities including oscillometry standardization, digital health implementation, and objective cough measurement will be critical to advancing both clinical trial support and global respiratory care.
References
Valach C, Gross C, Veneroni C, et al. Reference equations for oscillometry in adults: data from the Austrian LEAD Study. ERJ Open Res 2025; in press (https://doi.org/10.1183/23120541.00159-2025)
Bell AD, McIvor RA. The SMART study. Can Fam Physician. 2007 Apr;53(4):687-8. PMID: 17872720; PMCID: PMC1952599 (https://www.astrazenecaclinicaltrials.com/study/D8210C00003/)
European Respiratory Journal 2023; 62: Suppl. 67, PA1292
