In the UAE, COPD remains largely underdiagnosed

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  • Boehringer Ingelheim releases breakthrough findings on COPD in new study published in the Lancet Respiratory Medicine
  • In the UAE, COPD has the lowest prevalence in the region. However, the disease is largely underdiagnosed, and hence undertreated until it is moderately advanced due to the lack of standardized diagnosis methods[1]
  • COPD represents a major health concern for developing countries and is ranked as the fourth leading cause of death worldwide. It is expected to become the third leading cause by the year 2030.[2]
  • People with COPD are likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation, and persist for at least several days.[3]

Dubai, United Arab Emirates: Boehringer Ingelheim, one of the world’s leading pharmaceutical companies, has released data from its landmark 52-week DYNAGITO® trial, involving more than 7,800 people with chronic obstructive pulmonary disease (COPD).

Among people with COPD, a lowered rate of moderate-to-severe exacerbations or flare-ups was discovered after the trial. The findings support[4] international Global Initiative for chronic Obstructive Lung Disease’s (GOLD)[5] 2018 strategy recommendations, that shed light on the central role treatments play in the management of COPD and help achieve key treatment goals that include reduced symptoms and minimizing the future risk of exacerbations.  This study has also been published in the Lancet Respiratory Medicine.

In the UAE, COPD is largely underdiagnosed and hence undertreated until it is moderately advanced due to the lack of standardized methods to diagnose COPD, lack of general information. In Abu Dhabi, a prevalence rate of COPD is found to be at 3.7% of the local population, with significance in those 70 years and older, according to a local study.[6]

COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus production and wheezing. It’s caused by long-term exposure to irritating gases or particulate matter, most often from smoking cigarettes. People with COPD are at an increased risk of developing heart disease, lung cancer and a variety of other conditions.[7]

Symptoms of COPD often don’t appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. These may include shortness of breath, chest tightness, excess mucus in the lungs, frequent respiratory infections, as well as lack of energy.[8]

In the Middle East and North Africa[9] (MENA), the prevalence of COPD has been estimated at around 4 per cent of adults aged over 40 years in the general population.

Dr. Bassam Mahboub, Head of Emirates Respiratory Society and Assistant Dean at the College of Medicine in Sharjah University said, “The UAE’s healthcare system has made remarkable strides in ensuring that it currently has the lowest prevalence[10] of COPD in the region, however, the need for data around COPD is of paramount importance. Early diagnosis is critical to managing the progression of COPD and improving chances of survival. Reduced flare-ups can positively impact disease progression and mortality. A flare-up can lead to a 25 per cent loss[11] in lung function often causing COPD to progress even faster[12].”

Dr. Mahboub also added, “Flare-ups are usually caused by infection in the lungs or airways and inhaling heavy air pollution. Such exacerbations in COPD can be prevented[13],[14] by smoking cessation, timely vaccination against flu and pneumonia, increased physical activity, adherence to prescribed medications for COPD, regular contact with doctors, adequate sleep, and staying hydrated.”

Dr. Mohamed Meshref, Boehringer Ingelheim’s Medical Director, META said, “At Boehringer Ingelheim, we are actively working to study and develop a close understanding of chronic respiratory diseases that are increasing in frequency, morbidity, and mortality. With their economic and social impact increasing rapidly, early intervention could result in significant reductions in cost and mortality. Largely preventable – it is important to work closely with the primary care service and government bodies to ensure better health outcomes for the population in the region that continues to have a high profile of cardiovascular and respiratory risk factors.”

One in three[15] people hospitalised may have to be readmitted after a flare-up within eight weeks. According to the World Health Organization (WHO), risk factors that contribute to developing COPD, which include tobacco smoking, indoor and outdoor air pollution as well as being exposed to occupational dusts and chemicals. The disease represents a major health concern for developing countries and is ranked as the fourth leading cause of death worldwide, and is expected to become the third leading cause by the year 2030[16].

For over 90 years, Boehringer Ingelheim has emerged as a leader in managing respiratory illnesses, having launched several treatments in a range of conditions including chronic obstructive pulmonary disease (COPD), asthma,  IPF and lung cancer. The company focuses on improving the quality of life of patients suffering from debilitating respiratory diseases and enabling them to maintain a more independent life.

About DYNAGITO®

The 52-week DYNAGITO® study is the first to investigate, as a primary endpoint, whether the LAMA/LABA tiotropium/olodaterol offers reduction in the annualised rate of moderate and severe exacerbations beyond the LAMA tiotropium in patients with moderate to very severe COPD (FEV1 < 60%) with at least one moderate or severe exacerbation requiring treatment with systemic glucocorticoids and/or antibiotics or hospitalisation in the previous 12 months. The DYNAGITO® trial is part of the large-scale TOviTO® Phase III clinical trial programme involving over 16,000 patients, designed to investigate the efficacy and safety of tiotropium/olodaterol in COPD [17],[18],[19],[20],[21],[22],[23], [24]

About Boehringer Ingelheim:

Innovative medicines for people and animals have for more than 130 years been what the research-driven pharmaceutical company Boehringer Ingelheim stands for. Boehringer Ingelheim is one of the industry’s top 20 pharmaceutical companies and to this day remains family-owned. Day by day, some 50,000 employees create value through innovation for the three business areas human pharmaceuticals, animal health and biopharmaceutical contract manufacturing. In 2016, Boehringer Ingelheim achieved net sales of around 15.9 billion euros. With more than three billion euros, R&D expenditure corresponds to 19.6 per cent of net sales.

Social responsibility comes naturally to Boehringer Ingelheim. That is why the company is involved in social projects, such as the “Making More Health” initiative. Boehringer Ingelheim also actively promotes workforce diversity and benefits from its employees’ different experiences and skills. Furthermore, the focus is on environmental protection and sustainability in everything the company does.

[1] COPD in the Middle East and UAE: An unrecognized underestimated epidemic| Journal of lung, pulmonary and respiratory research | medcraveonline.com/JLPRR/JLPRR-03-00089.pdf

[2] WHO | Chronic Obstructive Pulmonary Disease http://www.who.int/respiratory/copd/en/

[3] Mayo Clinic | COPD | https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679

[4] Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2018 Report. Available at: http://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf [last accessed January 2018]

[5] Global Initiative for Chronic Obstructive Lung Diseases

[6] COPD in the Middle East and UAE: An unrecognized underestimated epidemic| Journal of lung, pulmonary and respiratory research | medcraveonline.com/JLPRR/JLPRR-03-00089.pdf

[7] Mayo Clinic | COPD | https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679

[8] Mayo Clinic | COPD | https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679

[9] Comorbidities associated with COPD in the MENA region: association with severity and exacerbations | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4751898/

[10] Mahboub B,et al, Case-finding of chronic obstructive pulmonary disease with questionnaire, peak flow measurements and spirometry: a cross-sectional study,  2014 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996099/

[11] Wedzicha JA, Donaldson GC. Repir Care 2003; 48(12):1204-13 https://www.ncbi.nlm.nih.gov/pubmed/14651761

[12] Wedzicha JA et al. Clin Chest Med 2014;35:157-63 https://www.ncbi.nlm.nih.gov/pubmed/24507843

[13] Halpin D et al. Int J Chron Obstruct Pulmon Dis. 2017; 12: 2891–2908. 12. COPD Foundation. Staying Health and Avoiding Exacerbations. https://www.ncbi.nlm.nih.gov/pubmed/29062228

[14] COPD Foundation. Staying Health and Avoiding Exacerbations.

Available at: https://www.copdfoundation.org/What-is-COPD/Living-with-COPD/Staying-Healthy-and-Avoiding-Exacerbations.aspx [Last accessed January 2018]

[15] Donaldson GC, Wedzicha JA. Thorax 2006;61(2):164-8 https://www.ncbi.nlm.nih.gov/pubmed/16443707

[16]   WHO | Chronic Obstructive Pulmonary Disease http://www.who.int/respiratory/copd/en/

[17] Buhl R, et al. Tiotropium and olodaterol fixed-dose combination versus mono-components in COPD (GOLD2-4). Eur Respir J 2015; 45(4): 969-79 https://www.ncbi.nlm.nih.gov/pubmed/25573406

[18] Ferguson F, et al. Efficacy of tiotropium+olodaterol in patients with COPD by initial disease severity and treatment intensity: a post hoc analysis. Adv Ther. 2015; 32(6): 523-526 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486785/

[19] Singh D, et al. Tiotropium+olodaterol shows clinically meaningful improvements in quality of life. Respir Med. 2015; 10: 1312-1319 https://www.ncbi.nlm.nih.gov/pubmed/26320402

[20] Singh D, et al.  Effects of tiotropium+olodaterol versus tiotropium or placebo by COPD disease severity and previous treatment history in the OTEMTO® studies. Respir Res. 2016 Jun 18; 17(1): 73 https://www.ncbi.nlm.nih.gov/pubmed/27316465

[21] Calverley P. Review COPD: what is the unmet need? British J of Pharma 2008; 115: 487-493 http://onlinelibrary.wiley.com/doi/10.1038/bjp.2008.362/full

[22] Reardon JZ et al. Functional status and quality of life in chronic obstructive pulmonary disease. Am J Med 2006; 119(10): 32-37 https://www.ncbi.nlm.nih.gov/pubmed/16996897

[23] WHO. Chronic obstructive pulmonary disease. Available from: http://www.who.int/mediacentre/factsheets/fs315/en/ [last accessed January 2018]

[24] Beeh KM, et al. The 24-h lung-function profile of once-daily tiotropium and olodaterol fixed-dose combination in chronic obstructive pulmonary disease. Pulm Pharmacol Ther 2015; 32: 53–59 https://www.ncbi.nlm.nih.gov/pubmed/25956072