The unmet needs in COPD
Understanding the clinical need of patients with COPD and modifying the impact of their disease are now a major focus of healthcare systems. Yet COPD continues to increase across both the developed and the developing world.1,2 So why is this occurring, and what are the unmet needs in COPD that account for this increase?
What are the unmet needs?
The pathogenesis of COPD is complex, and studies have demonstrated that airway inflammation plays an important role.3,4 The inflammation seen in COPD is clearly different from that seen in asthma, with a predominantly neutrophilic rather than eosinophilic bronchitis.5,6 The lung is a primary target for neutrophil recruitment and activation7 and the neutrophil is a primary mediator of inflammation in COPD. Reducing COPD-specific inflammation is a major unmet need in COPD management that is adressed by few treatments.
The other major unmet clinical needs are summarized below.
Unmet needs in COPD.
- More effective diagnosis and disease prevention
- Better symptom control
- Prevention of exacerbations
- Slowing and possible prevention of disease progression
- Reduction of disease-related mortality
- Identification and reduction of systemic disease secondary to COPD and comorbidities
Adapted from Calverly PMA. COPD: What is the unmet need? Br J Pharmacol 2008;155:487-93.8
Chapman KR, Mannino DM, Soriano JB, et al. Epidemiology and costs of chronic obstructive pulmonary disease. Eur Respir J 2006;27:188-207.
Buist AS, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet 2007;370:741-50.
- Hogg JC, Chu F, Utokaparch S, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 2004;350:2645-53.
Barnes PJ. Immunology of asthma and chronic obstructive pulmonary disease. Nat Rev Immunol 2006;8:183-192.
Barnes PJ. Mechanisms in COPD: differences from asthma. Chest 2000;117(suppl 2);10S-14S.
Sutherland ER & Martin RJ. Airway inflammation in chronic obstructive pulmonary disease: comparisons with asthma. J Allergy Clin Immunol 2003;112:819-27.
Saetta M. Airway inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999;160:S17-20.
Calverley PMA. COPD: What is the unmet need? Br J Pharmacol 2008;155:487-93.