New Survey Reveals Heavy Burden of COPD and COPD Lung Attacks in Asia, including Philippines

1 of 4 of those with COPD symptoms in surveyed countries remain undiagnosed
COPD poses a heavy burden burden in Asia, particularly in the Philippines: Among the Filipino respondents, 62% were unable to work, and 70% of those able to work full-time or part on average miss 14 days at work

Majority of sufferers worry about COPD lung attacks affecting their quality of life
Once daily tablet, roflumilast, a first-in-class treatment is launched to target the underlying cause of COPD and reduce risk of COPD lung attacks

COPD is a debilitating disease which poses a significant burden in Asia. Key findings from the new landmark “Epidemiology and Impact of COPD in Asia” Survey  (EPIC Asia Survey) show that COPD affects the quality of life and impacts work productivity. Yet the disease is still largely underdiagnosed and sub-optimally treated with almost half of those surveyed with COPD symptoms still undiagnosed. 
Undertaken by Takeda, a global pharmaceutical company, the EPIC Asia Survey is a large-scale, community-based study and the first of its kind in Asia. The survey screened over 112,000 households in China, Hong Kong, Indonesia, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam to gather insights. It involved over 1,800 respondents with either diagnosed or suspected COPD across Asia including 200 respondents from Philippines and has provided greater insight into the burden, perception and understanding of this progressive and deadly lung disease.

According to the EPIC Asia survey, the prevalence of COPD in those aged over 40 in Philippines is estimated to be around 4.2%. The survey also found that about one in five COPD patients  in the surveyed countries fall into the severe phenotype category experiencing cough and sputum with frequent exacerbations. These are patients with a severe or very severe stage classification, or patients diagnosed with chronic bronchitis and experiencing cough and sputum with frequent exacerbations (2 or more in past year).

COPD is a persistent lung disease where breathing is restricted due to lung damage and inflammation. It is a major health problem with about 65 million people globally suffering from COPD, according to the World Health Organization (WHO) . COPD is currently the fifth leading cause of death worldwide and the WHO predicts it will rise to third by 2030.

Heavy burden of COPD

COPD simulation
The EPIC Asia survey highlights the heavy socio-economic burden and struggle of those with COPD. 62% of respondents from the Philippinesnot employed full-timewere unable to work because of their condition. Amongst those who were employed full-time or part-time, 70% missed days at work because of their COPD condition, during the last 12 months.

The EPIC Asia Survey revealed that in the last 12 months, respondents from the Philippines had stayed home an average of 11 days because of their condition. 

The burden of COPD is intensified when a patient suffers from a lung attack. COPD lung attacks, or exacerbations, are a debilitating aspect of COPD (where a patient’s day to day symptoms worsen). According to the region-wide survey, close to half (46%) of those surveyed had suffered a lung attack in the last 12 months.In the Philippines, 34% suffered a lung attack in the last 12 months. These episodes of symptom worsening last an average of about 7 days and the symptoms that were more common or frequent during these episodes included coughing during the day and coughing up of phlegm or sputum.

COPD lung attacks are associated with increased airway and systemic inflammation and physiological changes in the lungs , . They include increased breathlessness and a chronic cough, mucus production, extreme fatigue and other signs of health deterioration. COPD lung attacks are also a major cause of hospitalization  and can lead to substantial morbidity and mortality. The survey found that in the last 12 months, 22% of respondents in Philippines visited a hospital emergency room because of their condition. 

COPD further impedes the lives of its sufferers as many live with the fear of an impending COPD lung attack. It was found that 68% of those with COPD worry about having a lung attack when they were away from home and 65% find it difficult to make plans because they never know how they will feel, affecting quality of life of the sufferers and their loved ones.

COPD management - A novel approach

Findings from the three-year ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points) study pointed to the need for improved future treatment strategies by encouraging COPD patients to plan for the prevention and management of exacerbations, regardless of disease severity . 

The launch of a new therapy seeking to treat the underlying cause of COPD could bring hope to COPD patients. The first-in-class treatment, roflumilast, aims to reduce the frequency of COPD lung attacks by treating the underlying airways inflammation in COPD. It is a once daily oral tablet indicated for the maintenance treatment of severe COPD associated with chronic bronchitis in adult patients with a history of frequent exacerbations, as an add-on therapy to bronchodilators. 

New data also shows that roflumilast helps to further stabilizes patients experiencing frequent COPD exacerbations. The post-hoc pooled analysis of two one-year, placebo-controlled studies involved more than 1,500 roflumilast-treated patients with severe COPD, chronic bronchitis and a history of COPD lung attacks. Among patients classified as frequent exacerbators, treatment with roflumilast over a year lowered the risk of remaining a frequent exacerbator by 20%. For patients classified as infrequent exacerbators, one year of treatment with roflumilast lowered the risk of having frequent exacerbations by 23%

About EPIC Asia Survey

The pan Asia survey involved the screening of 112,000 households and over 1,800 respondents with COPD covering China, Hong Kong, Indonesia, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. The population interviewed were randomly selected and included patients who were aged 40 or older and had been diagnosed as having COPD, chronic bronchitis, emphysema, or meet the symptomatic definition of chronic bronchitis. The survey is sponsored by Takeda and implemented by global research firm Abt SBRI. Field work was conducted in the first half of 2012.
About COPD
COPD remains a significant area of unmet medical need. It is a progressive lung disease resulting in difficulty in breathing. The most common symptoms of COPD are breathlessness, excessive production of sputum (a mixture of saliva and mucus in the airways) and a chronic cough. It is associated with an enhanced inflammatory response of the lung tissue to prolong exposure to inhaled pollutants such as cigarette smoke, and indoor use of wood or coal-burning stoves and heaters. The enhanced inflammation causes structural changes and progressive narrowing of the airways, resulting in difficulty in breathing and serious long-term disability.
The disease is characterised by severe episodes of worsening of symptoms, called exacerbations or lung attacks, leading to substantial morbidity and mortality.  According to the World Health Organization (WHO), an estimated 65 million people have moderate to severe COPD.  In 2005, more than three million people died of COPD and the disease is predicted to become the third leading cause of death worldwide by 2030.i

About Roflumilast (Daxas®)

Roflumilast (Daxas®) is an orally administered selective phosphodiesterase 4 (PDE4) enzyme inhibitor, which has been shown to inhibit COPD related inflammation with a novel mode of action. Roflumilast, a once-a-day tablet, is the first drug in a new class of treatment for COPD. It is also the first oral anti-inflammatory treatment for COPD patients. Current pharmacological treatment for COPD patients includes the use of inhaled bronchodilators and inhaled corticosteroids. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) included roflumilast as a new treatment option in the 2011 update of its COPD management guidelines, acknowledging its principal action to reduce inflammation and the clinical implications in terms of exacerbation reduction in GOLD 3 and 4 COPD patients. 

About Takeda

As the largest pharmaceutical company in Japan and one of the global leaders of the industry, Takeda is committed to strive towards better health for patients worldwide through leading innovation in medicine. Additional information about Takeda is available through its corporate website:

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