This session will provide a forward looking discussion around concepts of disease modification and future opportunities to change the course of chronic respiratory disease. It will bring forth new treatment paradigms that will ultimately impact the goals of therapy. There will be a review of the current landscape of disease progression and modification in respiratory medicine (e.g. IPF, ILDs, CF, A1T1-deficiency) and other therapeutic areas (e.g. RA, IBD), to identify potential parallels with chronic obstructive lung disease. Additionally, we will identify considerations required for conducting clinical research such as relevant clinical end-points (including technological approaches e.g. imaging) and molecules that may have the potential to modify the course of Respiratory disease.