Shining a Light on The Global Burden of COPD – Sponsor Content
This chronic lung disease is a leading cause of death and a major public health issue. Here’s how scientists and global leaders can help make a difference.
Heart disease. Cancer. Alzheimer’s. These conditions are among the most well-known and studied in the world. They are also among the leading causes of death, according to a 2024 global study. Chronic obstructive pulmonary disease (COPD) is also a leading cause of death, but unlike the others, has remained under-prioritized for decades. In 2023, COPD research received less than two percent of the funding that cancer received, according to the National Institutes of Health. What’s more, it’s expected that COPD will cost the global economy $4.3 trillion between 2020 and 2050.
Chances are, maybe without even realizing it, you know someone suffering from COPD, a condition that can cause irreversible damage to a person’s lungs, impeding airflow and leading to difficulty breathing. Patients often do not know they are affected by the disease. Because the disease can also encompass chronic bronchitis and emphysema, and symptoms like persistent cough, excessive mucus production and shortness of breath can vary from person to person, misdiagnosis and delay of diagnosis is unfortunately common early in the disease trajectory.
As the disease progresses, coughing attacks (or exacerbations) often increase in severity. Rapid lung function decline is also associated with greater risk of heart disease, leading to increased hospitalizations and spiraling medical costs, and most importantly, increased mortality. And contrary to popular belief, smoking isn’t the only underlying cause. Another common risk factor is living with elevated levels of air pollution, which now impacts 99 percent of the global population, according to the World Health Organization (WHO). With more people bound to develop the disease and its role in contributing to comorbidities, COPD must be studied more deeply to find ways to help mitigate its impact and improve the health of patients.
To help address the impact of COPD on patients and communities, global healthcare companies Sanofi and Regeneron are working together to study the ripple effects of COPD and to help create a better future for communities, hospitals, and, most importantly, patients suffering from the disease.
To learn more about how widespread this disease is and what it will take to progress our understanding of the disease forward, we talked with three experts in the field: Dr. Nicola Hanania, professor of Medicine-Pulmonary at Baylor College of Medicine; Manuela Buxo, Global Head of Immunology at Sanofi; and Dr. Yamo Deniz, Vice President, Global Medical Affairs & Head of Immunology and Inflammation Global Medical Franchise at Regeneron.
Given its severity, why hasn’t COPD been more recognized as a threat to public health?
Manuela Buxo
Even though many people suffer from COPD, the lack of recognition it gets as a public health issue may be due to a combination of things. Patients who previously smoked may blame themselves because they think it’s self-inflicted. However, for a long time, the devastating consequences of smoking weren’t known. Even doctors smoked. But today, there’s a stigma that comes with that when people say, “Well, you should not have started in the first place.” Beyond that, we have to realize that it’s an addiction, like many other addictions. Willpower alone won’t help most patients. And while COPD is sometimes referred to as “smoker’s lung,” it is important to realize that many COPD patients do not have a history of smoking.
Dr. Nicola Hanania
We are underdiagnosing COPD for a few reasons. One is that patients come to us late. They don’t realize that their cough is a serious problem. They think their exercise limitation is just part of the aging process. Another reason is that, as clinicians, we don’t always have it on our radar because there’s been an attitude that we cannot do anything for these patients, which is not true. All guidelines state that COPD is indeed a treatable disease, so that’s the word we want to get across.
Dr. Yamo Deniz
Unfortunately, our healthcare systems are currently not recognizing unmet needs for COPD patients. Many people, for instance, may not realize that the current standard-of-care inhaled therapies, such as bronchodilators, help patients manage symptoms, but may not address the underlying chronic lung inflammation that causes their disease to progressively worsen. Consequently, a significant number of patients with COPD may experience recurrent exacerbations each year, despite standard-of-care treatment, resulting in loss of lung function. It’s only now that we are starting to have a better understanding of the immunologic basis of the disease.
What are the most common misconceptions you see and hear around COPD that lead to deprioritization among healthcare system leaders?
Dr. Nicola Hanania
There are several myths about COPD that we’re still trying to battle. One is that it’s a disease of old men. It’s actually not a disease of the old, and it’s not a disease of men. In fact, anyone above 40 who has risk factors like genetics or childhood respiratory issues can have COPD. And actually, more women in the United States have COPD than men, and die from it.
Also, I see many non-smoking patients who suffer from COPD in my clinic. Many of these are immigrant patients from countries where people use different types of fuel or biomass for cooking. They have severe COPD and yet have never smoked a cigarette. Others have lived with a partner who smoked. So I think if we’re going to treat this as the major epidemiologic problem it is, we have to think outside the box regarding risk factors. It’s not about just smoking.
Beyond affecting the individual, how does COPD impact caregivers, broader communities and society at large?
Manuela Buxo
COPD progressively drains the welfare and resources of patients, caregivers, and healthcare systems across the world. Given climate change, we know respiratory diseases will keep rising in general. A lot of patients need increasing assistance as they deteriorate. Recurrent exacerbations decline lung function and cause a downward spiral, propelling further disease progression and leading to more severe and frequent exacerbations. As such, nearly 70 percent of COPD-related healthcare costs are connected to hospitalizations and readmissions. Then factor in the socioeconomic costs for COPD, like missing work and how it can lead to early retirement for many people, and suddenly you see how it’s a bigger deal than people realize. It’s something on which we want to shine a light.
What is the latest research on COPD?
Dr. Yamo Deniz
Our understanding of COPD has evolved from one regarding it as a condition where the lungs are badly damaged causing poor airflow to now realizing that it’s a heterogeneous disease and that cytokines [signaling proteins that regulate inflammation in the body] play different roles in different patient populations. This realization is changing how we evaluate patients because not everybody will have the same disease process. Driven by different cytokines, COPD may vary across patients, so the scientific community is increasingly exploring approaches to more precisely address these distinct patient types.
Dr. Nicola Hanania
Patients have flare-ups or exacerbations in the course of the disease. These episodes can worsen and push people into hospitals. And even with the therapies we have now, patients can continue to have these flare-ups.
We know that underneath the surface of the lung, COPD is caused by airway inflammation. Patients also have narrowing in their airways due to inflammation and blockage caused by mucus plugging of the airways. Definitely in the year 2024, compared to when I started 30 years ago, we have a new outlook on this old disease.
Given how many people COPD affects, how has your own personal experience led to your commitment to COPD research?
Manuela Buxo
My grandpa passed away from COPD. He was a farmer and a bear of a man who also smoked earlier in his life. When he was diagnosed with COPD, his health started to decline significantly. To see a man like that struggle with breathing when going up stairs and not being able to sleep without oxygen was hard. That’s why my work in COPD is personal. It’s a disease that impacts not just the patient, but also the entire family.
Dr. Yamo Deniz
I have dedicated my whole career to the study of allergy and immunology with a focus on diseases with serious unmet needs like COPD. My family is a huge source of inspiration for me pursuing this field. Growing up, I looked up to my uncle, who was diagnosed with COPD after years of smoking. I watched as COPD slowly deteriorated his ability to breath and gravely impacted his overall quality of life. He has since passed away, and I often think about him in our pursuit to research and better understand this disease to help physicians take care of patients.
What does the future look like for COPD and those suffering from it?
Dr. Yamo Deniz
The broader healthcare community, including companies such as Regeneron and Sanofi, are now more than ever finding new ways to address this unbelievably burdensome disease in order to help patients, their families and society. From a research perspective, we want to push the boundaries of science even further. Today, advancements enable better understanding of the disease than decades past, which allows us to move the goal post for the future. Looking ahead, perhaps we will see the day where we help patients not only to breathe better, but to also help prevent further damage and combat the progressive nature of the disease. With scientific advancements, it will be essential to collectively work toward a future where COPD patients are supported through each stage of their disease journey and families have the resources needed.
Manuela Buxo
Regeneron and Sanofi are working as an alliance—and we work really well together. These types of partnerships are important because one company alone can’t do this. Going forward, I think healthcare companies will continue to invest in this space and try to generate more and better science to help patients. At the same time, we want to make sure that there is awareness and understanding that this is a complex and heterogeneous disease, and we need different options, different alternatives to really benefit patients and the surrounding community. So that’s something that we are very committed to, and we hope others are as well. We hope everyone starts taking this disease as seriously as we are.
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