Experts: COPD an epidemic 'time bomb'

SEOUL – Health experts have described chronic obstructive pulmonary disease (COPD) as an epidemic “time bomb” that may explode in the Asia-Pacific if no urgent actions are taken to curb the trend.

Sam Lim, acting associate dean in Duke-NUS Graduate School of Medicine in Singapore, said more people in the Asia-Pacific are developing COPD although the illness is preventable.

“This is a disease which previously has not generated as much interest as asthma because asthma takes young people and COPD affects the elderly,” Lim said in a press conference organized by Takeda Pharmaceuticals (Asia Pacific) Pte Ltd.

COPD, which afflicts Filipino comedy king Dolphy, is characterized by chronic inflammation of the lungs causing structural changes and progressive narrowing of the airways. The inflammation is primarily triggered by chronic exposure to inhaled irritants.

The disease “represents significant areas of unmet medical needs with the majority of available treatments designed to treat asthma.”

5th leading cause of death

Lim noted that mortality and morbidity related to COPD were predicted to be higher in the future. “The deaths are predicted to increase in the next 10 years,” he said.

Based on World Health Organization (WHO) estimates, Lim said 65 million people globally are suffering from COPD. The disease is now the fifth leading cause of death in the world and is expected to climb to third place by 2030.

Smoking causes COPD, according to Lim.

“Stop smoking, this is a murderer that can kill you in more than two dozen different ways. Smoking is the main contributor and Asia-Pacific is the highest for smoking. Some countries in Asia-Pacific, which are much poorer, are countries that can ill afford the economic burden of smoking – costs of hospitalization and lost productivity,” he said.

To address COPD, the Takeda company conducted the “Epidemiology and Impact of COPD in Asia (EPIC)” survey in 100,000 households in China, Hong Kong, Indonesia, Malaysia, Singapore, Taiwan, Thailand, Vietnam and the Philippines in the first half of 2012.

The survey involved more than 1,800 respondents with either diagnosed or suspected COPD.

Results showed the prevalence of COPD among those surveyed aged over 40 was around six percent, while 41 percent of those with symptoms are still “undiagnosed.”

Nineteen percent of COPD cases in Asia-Pacific fall into the “severe phenotype category, experiencing cough and sputum with frequent COPD lung attacks or exacerbation.”

The survey showed 46 percent of the respondents have suffered lung attack in the last 12 months, with symptoms lasting for 13 days.

The Takeda firm has come up with the first oral anti-inflammatory treatment especially designed for COPD. The medicine has a unique mode of action – phosphodiesterase 4 (PDE-4) inhibition which targets inflammation. It reduces exacerbations and improves the lung function when added to long acting bronchodilators.

According to Teresita de Guia, head of the Pulmonary and Critical Care Medicine at the Philippine Heart Center, the burden of COPD is intensified if a patient suffers from lung attack, which is associated with “increased airways and systemic inflammation and physiological changes in the lungs.”

De Guia, who is also the head of the COPD Foundation, warned that a patient could die if his level of oxygen goes down to critical level during a lung attack.

Based on the survey, lung attacks are the major cause of hospitalization of many COPD patients.

During a lung attack, a patient may experience increased breathlessness and chronic cough, mucus production, extreme fatigue and other signs of health deterioration.

She said that while COPD is not curable, it is important for sufferers to get proper medication and management to prevent the condition from deteriorating.

De Guia said a patient who is suffering from Stage 4 COPD has less than 30 percent of his lungs functioning and will have to spend some P5,000 a month for medicine.