Disease Overview
Chronic obstructive pulmonary disease (COPD) is defined by persistent airflow limitation (reduction in the ability to exhale at a normal rate and volume). While chronic and progressive dyspnea (shortness of breath) is a key symptom, patients may also present with productive cough. Significant exposure to noxious particles or gases, namely tobacco smoke, is the primary cause of the underlying alveolar and airway abnormalities that result in the airflow limitation and respiratory symptoms that characterize the disease. However, other environmental and occupational exposures or genetic abnormalities may also contribute to symptoms.
Latest Key Takeaways
Chronic obstructive pulmonary disease (COPD) is defined by persistent airflow limitation (reduction in the ability to exhale at a normal rate and volume). While chronic and progressive dyspnea (shortness of breath) is a key symptom, patients may also present with productive cough. Significant exposure to noxious particles or gases, namely tobacco smoke, is the primary cause of the underlying alveolar and airway abnormalities that result in the airflow limitation and respiratory symptoms that characterize the disease. However, other environmental and occupational exposures or genetic abnormalities may also contribute to symptoms.
Latest Key Takeaways
- The publisher estimates that in 2018, there were approximately 307.0 million prevalent cases of chronic obstructive pulmonary disease (COPD) worldwide, and forecasts that number to increase to 328.9 million prevalent cases by 2027.
- The “ABCD” GOLD treatment guidelines focus on exacerbation risk and patient-reported outcomes to determine pharmacological treatment strategies, independent of spirometric value.
- Dual bronchodilator combinations are being considered as the new gold standard over long-acting muscarinic antagonist (LAMA) Spiriva in the treatment of more severe COPD.
- Triple inhaled corticosteroid/long-acting beta 2 agonist/long-acting muscarinic antagonist (ICS/LABA/LAMA) fixed-dose combination therapies delivered through a single inhaler bring convenience to more severe patients. For Breztri Aerosphere’s FDA submission, AstraZeneca included data from the KRONOS study, but the ETHOS trial did not complete primary endpoints until mid-2019. As such, the FDA issued a complete response letter to AstraZeneca, benefitting rival GlaxoSmithKline’s marketed Trelegy Ellipta as the only triplet on the US market. More recently, Breztri has gained approval in the US and Europe.
- IL-5 inhibitors have disappointed in the broader population of more severe COPD patients. However, ongoing studies are evaluating AstraZeneca’s Fasenra and GlaxoSmithKline's Nucala in individuals with high eosinophils. Topline results from Fasenra’s RESOLUTE and Nucala’s MATINEE trials are expected in the coming years, while Phase III results from Sanofi and Regeneron’s dual IL-4 and IL-13 inhibitor Dupixent are expected in 2023.
- Nebulizers are limited by convenience and often are being developed by smaller companies that lack the commercial resources of large pharma.
Table of Contents
OVERVIEW
DISEASE BACKGROUND
TREATMENT
EPIDEMIOLOGY
KEY REGULATORY EVENTS
LICENSING AND ASSET ACQUISITION DEALS
CLINICAL TRIAL LANDSCAPE
DRUG ASSESSMENT MODEL
FUTURE TRENDS
RECENT EVENTS AND ANALYST OPINION
UNMET NEEDS
BIBLIOGRAPHY
LIST OF FIGURES
LIST OF TABLES