On November 21, World COPD Day 2018, the National Institutes of Health unites with millions of people to renew our long-standing commitment to reducing the burden of chronic obstructive pulmonary disease (COPD), a serious and debilitating lung disease. A leading cause of death, COPD impacts an estimated 251 million people worldwide. While many have been diagnosed with the disease, millions more are believed to have it and not know it. In the United States, 16 million people have COPD, and each year more than 150,000 people die because of it.
The numbers tell only part of the story, however. For many who live with the disease, getting through each day is often a struggle. COPD (also known as emphysema or chronic bronchitis) can make it difficult to breathe or perform even the most basic tasks. And because COPD symptoms develop slowly and worsen over time, many who have the disease delay getting diagnosed until they need aggressive treatment or hospitalization. This further compounds the toll on their lives—and on the nation’s health care system: COPD-related care cost Americans more than $32 billion in 2010, a number expected to increase to $49 billion by 2020.
Through its large research portfolio, the NIH is working hard to make inroads into the fight against this crippling disease. In 2017, NIH’s National Heart, Lung, and Blood Institute (NHLBI) developed the COPD National Action Plan in collaboration with federal and nonfederal partners. This comprehensive, unified plan now serves as a guiding document for those affected by COPD and for those invested in doing something about it. At NIH, intensive COPD research is being conducted and supported at all stages, from the laboratory to clinical trials. Some of it has improved our understanding of COPD and resulted in effective treatment strategies that are used in practice today.
The Nocturnal Oxygen Therapy Trial has given researchers insight into ways long-term oxygen therapy can improve the life expectancy of patients with advanced COPD. The Lung Health Study is helping researchers understand how smoking cessation interventions impact the long-term survival of COPD patients. The National Emphysema Treatment Trial is showing how lung volume reduction surgery might improve the quality of life in certain groups with severe COPD.
NIH also supports other studies, many conducted through the NIH COPD Clinical Research Network, that are exploring the effectiveness of various pneumococcal vaccines in COPD patients; the usefulness of azithromycin, an antibiotic, in reducing the severity and occurrence of COPD exacerbations; and the role statin drugs might play in preventing or eliminating those exacerbations. In cooperation with the Centers for Medicare and Medicaid Services, NIH is also supporting the Long-Term Oxygen Treatment Trial, which builds on previous studies that looked at whether supplemental oxygen is beneficial to patients with mild COPD. Other studies are aimed at improving knowledge about the biologic basis of COPD and its biomarkers.
These studies are critical to the research activities of NHLBI-supported scientists, who focus on advancing understanding of the disease process, identifying crucial points in its onset and progression, and sharing the knowledge necessary for early intervention and prevention. The COPDGene Study is currently investigating why some smokers develop COPD while others do not. (Smoking accounts for 75 percent of COPD cases; secondhand smoke, environmental pollutants, and genetic factors also play a role.) Other studies are evaluating how various pharmaceutical medications affect the treatment of COPD. NHLBI also funds research to find out if a proven weight loss and physical activity program can improve COPD symptoms for those with a high body mass index (BMI). Finally, scientists are continuing their research on the CAPTURE tool, a case-finding mechanism that involves a simple questionnaire and breathing test, that can help health care providers identify people at risk for developing COPD before their symptoms get severe.
To further advance the awareness and understanding of COPD nationwide, NHLBI – through its COPD Learn More Breathe Better program – is working with health care providers to facilitate discussions with patients in the exam room to make earlier diagnosis more possible. To reach the greatest number of patients, the program collaborates with a large network of partners.
The NIH is thankful for all these collaborators, as well as the many other individuals and entities—from researchers to advocates—who are helping advance the care and management of COPD. By working together to improve awareness and early diagnosis of the disease, we can have a lasting—and positive—impact on the health of the millions who struggle with COPD in the United States and around the world.