New treatment for COPD available in PH

Underdiagnosed yet alarming, this respiratory disease may be the third leading cause of death in 2030.

There is a tsunami of chronic obstructive pulmonary disease (COPD) cases worldwide, said Dr. Kenneth Chapman, professor of medicine at the University of Toronto, during the media briefing titled “Breathe Free, Break Free,” organized by Novartis Healthcare Philippines (NHP) last Sept. 26 at Edsa Shangri-La Hotel in Mandaluyong City.

According to the World Health Organization, COPD is not one single ailment but an umbrella term used to describe chronic respiratory diseases that cause limitations in lung airflow. Symptoms are breathlessness or a “need for air,” excessive sputum production and chronic cough.

At risk to COPD are those who smoke, and those constantly exposed to indoor air pollution (such as biomass fuel for cooking and heating), outdoor air pollution, and occupational dusts and chemicals. One in five Filipinos (14 to 20 percent) have COPD, but only 3 percent consult a doctor and about 50 percent are not aware they have the disease, according to the Philippine College of Chest Physicians (PCCP).

Chapman said although COPD is incurable, there are treatment and methods to reduce/reverse symptoms as much as possible. That is why he and other speakers during the event are actively pushing for more proactive action and corrective measures to prevent the occurrence and correct diagnosis of COPD.

Coinciding with the forum is the launch of a new, once-daily inhaler, glycopyrronium bromide, that works as quickly as 5 minutes and lasts for as long as 24 hours. A product of research-based Swiss healthcare company Novartis, glycopyrronium bromide is a type of long-acting bronchodilator, a drug that widens air passages of the lungs.

Dr. Francis Domingo, NHP chief scientific officer, said it “gives them the flexibility of having the right treatment for the right patient at the right time.”

A looming threat

COPD affects an estimated 210 million people worldwide. By 2030, COPD will be the third leading cause of death in the world, according to the WHO. Although COPD is often thought of as a disease of the elderly, an international survey found that 50 percent of patients are estimated to be within the ages of 50 and 65. This means that half of COPD patients are likely to be impacted at the peak of their earning power and family responsibilities.

Dr. Ricardo Zontomayor, cochair of the Asthma Council of the Philippine College of Chest Physicians (PCCP), said that 50 percent of COPD cases are either not diagnosed or undetected because “patients underestimate and fail to report symptoms.” He added that “physicians also fail to diagnose it because they were not asking the right questions and are underutilizing methods to detect it.”

Misdiagnosis of COPD further aggravates the problem, Chapman said, because doctors were using medicines not intended for COPD, “making things worse. “Twenty-three percent [of cases] are even prescribed as asthma, causing complications [like the increased risk to tuberculosis because of inhaled corticosteroids which are intended for COPD].”

Meanwhile, Dr. Teresita de Guia, chair of COPD Foundation of the Philippines and PCCP Council on Critical Care and Pulmonary Vascular Disorders, said early intervention reduces the risk of disease progression and the exacerbation of its symptoms as well as lessens mortality rates. Pharmacological treatments not only reduce activity-induced shortness of breath and exacerbations but also improve exercise tolerance and health-related quality of life. Smoking cessation slows down disease progression, she explained.

Zotomayor stressed that COPD should be considered in any individual 40 years and above who had history of exposure to tobacco smoke; smoke from home cooking or heating fuel, and/or occupational dust/chemicals. He advised those who usually experience shortness of breath, chronic cough, chronic sputum production and family history of COPD to undergo a simple diagnostic test called spirometry, which measures how much air a person can inhale and exhale, and how fast air can move into and out of the lungs.