Source: Official U.S. Navy Page via Flickr.
A chronic obstructive pulmonary disorder, or COPD, diagnosis may not drive fear into patients like hearing the word "cancer," but make no mistake about it, it's a serious and life-threatening disease that affects people across the U.S. regardless of their sex, age, education level, and socioeconomic status. It's also the primary reason why chronic lower respiratory disease is the third-leading cause of death in this country.
For those unfamiliar, COPD is a progressive and currently incurable disease whereby the airways of a person's lungs make more mucus than normal or lose their elasticity which can make it harder to breathe. The two main types of COPD are chronic bronchitis, characterized by excess mucus production, and emphysema whereby the walls surrounding the sacs in your lungs are being slowly destroyed.
COPD can be particularly dangerous as it can leave patients at higher risk for heart problems and respiratory infections, depression, and can make simple things like getting around more difficult because they can constantly feel as if they're out of breath. Not to mention, the direct costs of treating COPD, as well as the indirect costs, add up to about $50 billion annually per the National Institutes of Health.
Five states where COPD is the most prevalent
Within the United States, there are more than 24 million people who currently suffer with this disease, or according to data from the Centers for Disease Control and Prevention, 6.3% of the U.S. population. As noted above, COPD is a disease that does not discriminate. Though there were notable trends identified in the 2011 Behavioral Risk Factor Surveillance System data that the CDC analyzed (such as smokers and lower-income individuals being more susceptible to developing COPD), the key point is that a COPD diagnosis can happen to anyone.
There are five states, however, where COPD prevalence is alarmingly high relative to the national average of 6.3%. These states are:
- Kentucky 9.3% of the surveyed population.
- Alabama 9.1%
- Tennessee 8.7%
- West Virginia 8%
- Oklahoma 8%
Source: Centers for Disease Control an Prevention & Behavioral Risk Factor Surveillance System 2011.
Researchers have studies that would back the idea that smoking is a big risk factor, and other factors like age, genetics, and certain occupational chemical or dust exposure can play a role in a person developing COPD.
Rays of hope
Despite there being no cure for COPD, there are a few rays of hope which should encourage COPD patients that improved quality of life and/or survival may be on the horizon.
A study released in 2011 by the CDC, for instance, which tracked COPD statistics from 1998 through 2009 noted that while overall COPD diagnoses didn't fall, the death rate incidence of COPD fell for men. Unfortunately, this is a disease that afflicts women more commonly than men, but it nonetheless represents baby steps in the right direction toward improved survival and patient quality of life.
The good news is that there are a few new therapies which recently hit pharmacy shelves, as well as one developing therapy, that could ultimately make a marked difference for COPD patients.
One step at a time
With a long history that's been focused on improving patients' respiratory health, it shouldn't be a surprise that the two latest COPD maintenance therapies come from GlaxoSmithKline (GSK 0.12%). In collaboration with Theravance (NASDAQ: THRX) the two developed Food and Drug Administration-approved inhaled COPD therapies Breo Ellipta and Anoro Ellipta.
Breo Ellipta via Theravance investor presentation. Source: Theravance.
What's unique about Glaxo and Theravance's next-generation drugs is they're considered LAMA/LABA, or long-acting muscarinic antagonist and long-acting beta-2 agonist, combo drugs. What researchers learned is that LAMA and LABA drugs by themselves weren't as effective as combining them into a combination drug. By doing so researchers noticed statistically significant improvements over prior-generation therapies with regard to patients' forced expiration volume within the first second. This vital lung capacity measure is a good gauge of how stable a COPD patients' lungs are remaining over time. Improved FEV1 levels could imply that patients' lung degradation could slow on these next-generation therapies and may provide better quality of life to COPD patients. Of course, only time is going to prove whether or not that guess is accurate.
Keep your eye on this experimental drug
A currently experimental therapy that I'd encourage everyone to keep their eyes on is Teva Pharmaceutical's (TEVA 1.85%) reslizumab.
Now here's the interesting thing: reslizumab isn't geared toward COPD at the moment. It's being tested in clinical trials as a treatment for uncontrolled moderate-to-severe asthma patients with eosinophilia. But, based on the phase 3 results released less than two weeks ago, its incredible efficacy is probably going to push Teva to test reslizumab as a treatment for COPD.
In its late-stage asthma study, reslizumab significantly improved lung function and asthma control, and most importantly, had a safety profile that was very similar to the placebo it was being tested against.
"Why is this important?" you ask? Earlier this past week AstraZeneca (AZN 5.38%) reported the results on its COPD drug benralizumab, which works along the same pathway as reslizumab, and while it did greatly improve lung function, it failed to meet its primary endpoint of reducing acute exacerbations. Furthermore, there were more treatment-related side effects with AstraZeenca's drug than the placebo. In other words, Teva's reslizumab might represent the perfect next-generation drug for COPD sufferers if the company decides to take this drug down that path. If it can generate similar results for COPD patients as it did for asthma sufferers, we could see a nice bump up in patient quality of life.
Source: Dr. Farouk via Flickr.
What really matters
Ultimately, it doesn't matter whether Teva or AstraZeneca lands the next FDA-approved COPD therapy on pharmacy shelves as long as the research toward a cure continues. Although I don't have COPD, I watched this disease affect my mother for more than a decade, so I fully understand what it can do to a person. Though the steps taken by the pharmaceutical industry might be construed as small, each step nonetheless counts toward the goal of curing this deadly disease. My hope is that we can look back on another decade-long CDC study many years from now and see both a decline in death rates for men and women, as well as witness a reduction in COPD incidence rates.
