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Chronic Obstructive Pulmonary Disease (COPD) Backgrounder
What is COPD?
Chronic obstructive pulmonary disease (COPD) is a progressive, life-threatening disease associated
with tobacco smoking, air pollution or occupational exposure, which causes obstruction of airflow in
the lungs resulting in debilitating bouts of breathlessness. Over time, the disease causes patients to
become less active1.
What is the prevalence and incidence of COPD?
COPD affects 210 million people worldwide2 and is projected to be the third leading cause of death by
20203. More than 12 million people, or 7% of the adult population, are diagnosed with COPD in the
United States, while an additional 12 million people probably have the disease but are undiagnosed4.
In Europe, 4-10% of adults are estimated to be affected5. According to the World Health Organization
(WHO), total deaths from COPD are projected to increase by more than 30% over the next 10 years
unless urgent action is taken to reduce the risk factors6.
What causes COPD?
Smoking is the primary cause of COPD3, with female smokers 13 times and male smokers 12 times
more likely to die from COPD than non-smokers7. However, smoking is not the only cause of COPD
and in some parts of the world it may not even be the major cause3. Exposure to second-hand smoke
or other indoor or outdoor pollutants can increase a person’s chance of developing COPD3. Some
people with COPD have worked for many years in places that are very dusty or smoky8, and the
American Thoracic Society has concluded that occupational exposure accounts for 10-20% of either
symptoms or functional impairment consistent with COPD3.
Who is at risk of COPD?
COPD used to be more common in men, but now affects men and women equally. This is because of
increased tobacco use among women and the higher risk of exposure to indoor air pollution (such as
solid fuel used for cooking and heating)6. Some people with COPD have lived in homes filled with
fumes from cooking stoves or fumes from heaters used to warm the home.
What are the symptoms of COPD?
The most common symptoms of COPD are breathlessness, abnormal sputum (a mix of saliva and
mucus in the airway), a chronic cough, wheezing and chest tightness. Daily activities, such as walking
up a short flight of stairs, can become very difficult as the condition gradually worsens6.
How is COPD diagnosed?
COPD can be diagnosed by a simple test called spirometry that measures how much air a person can
inhale and exhale, and how fast air can be breathed out. Most people with COPD are not diagnosed
until the disease is well advanced. Physicians may consider COPD and perform spirometry if any of
these indicators are present in someone over the age of 403:
 Chronic cough
 Phlegm production
 Dyspnea (shortness of breath) that worsens over time, is worse with exercise and is present
every day
 History of exposure to tobacco smoke, occupational dusts and chemicals, smoke from home
cooking or heating fuels3
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CH-4002 Basel, Switzerland
©
2011 Novartis Pharma AG
For Media Use Only
However, COPD is often under-diagnosed because patients are not properly tested to detect the
disease9. Since patients may attribute symptoms to their smoking habit or aging, they do not seek
help and remain undiagnosed until they experience serious worsening of their condition. This
contributes to the fact that at diagnosis, up to 50% of lung function may already have been lost10.
How is COPD treated?
There is no cure for COPD, so the primary goal for treatment is to provide relief of symptoms and
prevent complications and/or progression of the disease with a minimum of side effects.
Bronchodilator medications that relax and open air passages in the lungs are central to the
symptomatic management of COPD. Most bronchodilators are taken using an inhaler device.
Depending on the severity of the disease, either short-acting or long-acting inhaled bronchodilators
may be prescribed.
Inhaled short-acting bronchodilators work quickly (within 15 to 20 minutes) and last from four to six
hours. They help to decrease shortness of breath and are sometimes described as rescue
medications.
Inhaled long-acting bronchodilators are used regularly to open the airways and keep them open for 12
hours and in some cases up to 24 hours. There are two main types of long-acting bronchodilator:
 Long-acting beta2-agonists (LABAs) which act on the beta2-adrenergic receptor, causing
smooth muscle relaxation and dilation of the bronchial passages
 Long-acting muscarinic antagonists (LAMAs) which work by inhibiting muscarinic receptors in
the bronchial airways, which leads to muscle relaxation and improved lung function
Inhaled corticosteroids are used to treat patients with COPD exacerbations. These medicines may
reduce airway inflammation and are prescribed with the aim of helping to relieve breathing problems3.
COPD treatments may contain either a single medication or a combination of medications in one
inhaler, such as a bronchodilator, a corticosteroid, a combination of bronchodilators, or a combination
of bronchodilator and corticosteroid.
Additional treatment can include antibiotics, oxygen therapy, pulmonary rehabilitation and surgery.
Pneumonia and influenza vaccines should also be given to COPD patients. Overall, COPD patients
should live a healthy lifestyle by exercising, avoiding cigarette smoke and other air pollutants.
What is the economic and workplace burden of COPD?
According to ‘COPD Uncovered: An international survey on the impact of chronic obstructive
pulmonary disease (COPD) on a working age population’11, COPD patients lose an average of around
USD1,800 of their income each year as a direct result of their disease, equating to an estimated
lifetime loss of nearly USD20,000 per individual. In addition, nearly one in five of 45-67 year olds with
COPD are forced to retire prematurely due to the condition, thereby incurring increased healthcare
utilization costs, reducing their personal tax and pension contributions, and increasing disability
allowance costs to governments.
How much does the general public know about COPD?
An international Social Observational Survey (SOS), conducted by the market research company
Opinion Matters on behalf of Novartis12 in August 2011, has revealed the widespread lack of
understanding and awareness of COPD among the general public. The survey, involving more than
6,000 people in six countries, found that:
 72% of those questioned thought COPD affects only smokers12
Novartis Pharma AG
CH-4002 Basel, Switzerland
©
2011 Novartis Pharma AG
For Media Use Only
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65% of those questioned did not realise that COPD can affect those under 65 years old, and 50%
did not believe women can be affected12
25% of those surveyed incorrectly thought COPD could be caught through infection12
18% thought that people with COPD are as active as the general population12
When asked to rank 10 diseases as the leading causes of mortality in the US and EU,
respondents placed COPD in 8th place12
Although COPD is often considered a disease of the elderly, 50% of patients are estimated to be
under the age of 65, and are likely to be at the peak of their earning power and family
responsibilities11. Furthermore, COPD used to be more common in men, but now affects men and
women equally13. Breathlessness, a key symptom of COPD, affects patients’ daily lives making them
less active and productive than the general population, but the survey shows that only a minority of
people recognize this.
The research involved a random sample of 6,222 members of the general public from Brazil (1,010),
China (1,010), Germany (1,010), Turkey (1,008), UK (1,180), and the US (1,004).
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References
1. Pitta F, Troosters T, Spruit MA, et al. Characteristics of Physical Activities in Daily Life. Am J Respir Crit Care
Med Vol 171. pp 972–977, 2005. Available at: http://ajrccm.atsjournals.org/cgi/reprint/171/9/972.pdf Last
accessed 26 July 2011.
2. Global Alliance Against Chronic Respiratory Diseases (GARD). Global surveillance, prevention and control of
chronic respiratory diseases: a comprehensive approach. Available at:
http://www.who.int/gard/publications/GARD%20Book%202007.pdf Last accessed 14 July 2011.
3. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis,
Management, and Prevention of Chronic Obstructive Pulmonary Disease. Updated 2010.
http://www.goldcopd.org/uploads/users/files/GOLDReport_April112011.pdf . Last accessed 1 August 2011.
4. National Heart, Lung, and Blood Institute. Morbidity & Mortality: 2009 Chart Book on Cardiovascular, Lung, and
Blood Diseases. Bethesda, Maryland: US Department of Health and Human Services, NIH, NHLBI. October
2009.
5. European Respiratory Society. European Lung White Book: Huddersfield, European Respiratory Society
Journals Ltd, 2003.
6. World Health Organization. Chronic Obstructive Pulmonary Disease Factsheet No. 315, Available at:
http://www.who.int/mediacentre/factsheets/fs315/en/index.html. Last accessed 14 July 2011.
7. American Lung Association. Chronic Obstructive Pulmonary Disease Fact Sheet. February 2010.
http://www.lungusa.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html. Last accessed 28 July
2011.
8. Global Initiative for Chronic Obstructive Lung Disease. What You Can Do About A Lung Disease Called
COPD. http://www.goldcopd.org/uploads/users/files/GOLD_Patient_RevJan10.pdf. Last accessed 28 July 2011.
9. Tinkelman DG, Price D, Nordyke RJ, Halbert RJ. Misdiagnosis of COPD and asthma in primary care patients
40 years of age and over. Journal of Asthma. 2006; 43:1-6.
10. Doherty D, et al. Chronic obstructive pulmonary disease: consensus recommendations for early diagnosis
and treatment. Journal of Family Practice. November 2006.
http://findarticles.com/p/articles/mi_m0689/is_11_55/ai_n27059405. Last accessed 26 July 2011.
11. Fletcher MJ et al. COPD Uncovered: An International survey on the impact of chronic obstructive pulmonary
disease (COPD) on a working age population. BMC Public Health 2011, 11:612.
12. Chronic Obstructive Pulmonary Disease (COPD) Social Observational Survey (SOS). Novartis data on file.
13. The World Health Organization. Chronic obstructive pulmonary disease (COPD). Fact sheet N°315. February
2011. http://www.who.int/mediacentre/factsheets/fs315/en/index.html. Last accessed 22 August 2011.
Novartis Pharma AG
CH-4002 Basel, Switzerland
©
2011 Novartis Pharma AG