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New Medications for COPD?

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Dear COPD Coach,
Why aren’t there more drugs out there for COPD? Other people with COPD that I talk with seem to all take the same medications. Also, I am always hearing about some big advances in research with other diseases, but I don’t hear much about COPD. What is going on?

—Looking for Answers

Dear Looking,
This is a topic that is very much a concern for those in the COPD community. However, the answer is not really an easy one to explain, but I will try.

The importance of research for COPD COPD is the third leading cause of death in the U.S., and unlike many of the other diseases, the numbers continue to rise. As far as new medications, much of this development depends on research. What is interesting to note is that despite this dubious distinction, COPD consistently gets the lowest levels of research funding. Simply put, without the research, cures and new treatments are slow in coming.

Even with research, drug makers must face many hurdles in order for their product to make it to market. As a part of this process, the drug companies must do extensive trials in order to establish such things as product safety, dosage, side effects, interactions with other drugs, to name a few. In order to conduct these trials, the investigators must establish a protocol and once approved must recruit a cohort, which is a group of patients who are willing to participate. Establishing a trial and recruiting a cohort can be difficult, expensive, and very time consuming. Some cohorts have taken as long as a year to recruit, and often are the biggest obstacle for drug makers to overcome.

Once the study has been completed, the findings and data are presented to the Food and Drug Administration (FDA), who reviews the material, and either approves it or recommends further testing or documentation. A public hearing is held to discuss the findings and final approval is either given or denied. It is not uncommon for the entire process to take years. Many potential drugs do not pass the trial stage! While we don’t want a dangerous drug to be rushed to market, we would certainly like to see development and approval move much more quickly!

So the question remains, what is the answer?

In short, the responsibility lies with many.

As far as research, the government bears a great deal of responsibility. Oftentimes other diseases that affect far fewer people, receive more research dollars simply because their patients are more vocal. As far as new treatments, much of this is shouldered again by the government’s lack of providing research dollars. The pharmaceutical companies in their search for such treatments are understandably concerned with costs of development as well as potential profits. The costs involved with bringing a drug to market are staggering.

The responsibility also lies with us, the patients. For too long we have sat back and allowed events to take their own course. In short, our voices were never heard. There are things we can do to change the process, and make the system work for us! What are they?

  • Join the COPD Patient-Powered Research Network, a research registry of over 75,000 individuals with COPD who have agreed to share their health information and the impact the disease has on their lives. Operated and governed by groups of patients and their partners, the information is kept in a secure database to be used for research – ultimately leading to a deeper understanding of the disease.
  • Get involved in advocacy efforts. Programs such as Operation 435 looks to reach out to all 435 members of the Congress to educate them on COPD and to make our views known. It requires nothing more than occasional phone calls or letter writing, but can – and will – make a huge difference.
  • Contribute! Even a few dollars can make a huge difference in speeding up and developing cures.

You can make a difference with just a little effort!

For more information on what you can do, call the COPD Information Line at 866-316-COPD (2673) and tell them you want to get involved!

–COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at coachescorner@copdfoundation.org. We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.

13 Comments



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  • Does anybody know of different kinds of drugs for COPD in more advanced countries?
    Reply
  • If COPD is pretty much irreversible due for example to scarring of the airways and breakdown of the alveoli, I don't see what medication could undo that damage. As I understand it the only other possibility is some sort of surgery?
    I am currently using Atrovent and Fostair with Seebri and n-acetyl cysteine. My condition is very much affected by humidity and pollen, and on those days the medication doesn't much help due I think to the amount of scarring and inflammation.
    What do others think? Can any medication undo the physical damage to airways?
    Reply
    • I took part in a pulmonary rehab class last year (which I highly recommend) which included a Q&A session with a pulmonologist. Someone in class asked him about some new COPD medications seen advertised on television recently, and whether or not, as a patient, how beneficial these "new" medications might prove to be. He told us that often what you see advertised as "new" is in fact an old medication renamed and repackaged. He said what prompts this by the manufacturers is because the patent the company has for a particular medication is about to expire. And when that happens other manufacturers can start making a generic of the same drug. And if that were to occur the drug companies would end up losing millions (billions?) of dollars in revenue. Of course, we as consumers would certainly benefit. So I wonder, what's the motivation for developing new drugs to "undo the physical damage to airways?" I personally don't believe there is any urgency to do that. Certainly not by BIG PHARMA. Because if there were such drugs, could we then stop using our Symbicort, Spiriva, etc.? Now that would be nice. But I'm not holding my breath.

      Reply
    • Davidgh
      Can we respond to you? btw you're not English are you? You write like an Englishman.
      Reply
    • Hi Soggybottombhoy - I attended a COPD Foundation Educational Workshop recently and learned that there are several new drugs that should be available later on this year. They are similar to Daliresp, which is a Phosphodiesterase 4 (PDE4) inhibitor, and reduces inflammation in many patients, thus reducing exacerbations. So while they and other drugs do not "undo" the physical damage, they may make life easier for some of us.
      Reply
  • Hi Karen. Thanks for the info. Those drugs will probably be marketed under a different name here in England, but I shall print off the names and ask my doctor about them.
    Over here our medication and treatment pretty much mirrors your own, but the difference is that you Americans are far more organised and open to alternative treatments. When I told my doctor about the benefits of n acetylcysteine for example, it met with a cool reception!
    You know that we have a State/tax funded health care system, and our medication is free if you're over 65 or have certain critical conditions?

    I haven't found a COPD blog similar to this
    Reply
    • Hi Karen. Thanks for the info. Those drugs will probably be marketed under a different name here in England, but I shall print off the names and ask my doctor about them.
      Over here our medication and treatment pretty much mirrors your own, but the difference is that you Americans are far more organised and open to alternative treatments. When I told my doctor about the benefits of n acetylcysteine for example, it met with a cool reception!
      You know that we have a State/tax funded health care system, and our medication is free if you're over 65 or have certain critical conditions?


      Reply
    • Hi Soggybottombhoy - from your screen name, I kind of thought you might be from England, so I'm glad I guessed correctly. The generic name for Daliresp is roflumilast, and it's been available for quite a few years in the US. (I believe it's called Daxas in the UK).






      Reply
  • Hi Karen.
    Found this..
    https://www.drugs.com/uk/daxas.html
    Side effects seem a bit grim, but I could do with losing a bit of weight...
    ps my real name is John -but don't let anyone else know.. :0)
    Reply
    • Hi Soggybottombhoy.
      I've been taking Daliresp (Roflumilast) for over a year now. And since taking it I haven't experienced any flareups. And the only side effect that I noticed was some gastrointestinal upset (diarrhea). The drug was designed to inhibit a protein called PDE4 which helps to reduce flareups. But after prolonged use, a study found that the drug increases a protein called PDE4B2, which increases inflammation. I told my doctor about the study I read concerning this, and asked if it would be OK if I took the drug every other day instead of everyday. I got his OK to proceed and haven't noticed any difference for the 3 months I've been skipping a dose.
      Reply
  • Hi Davidgh,
    "I told my doctor about the study I read concerning this, and asked if it would be OK if I took the drug every other day instead of everyday. I got his OK to proceed and haven't noticed any difference for the 3 months I've been skipping a dose. "
    Now that's good doctoring. My doctor allows me to skip stuff just to avoid the body getting too used to a particular medication.
    I should think the majority of COPD sufferers are ex smokers. I am, but to demonstrate my stupidity further I smoked even though I was a long term asthmatic, so in certain weather conditions or various 'triggers' the asthma kicks in. But you wouldn't know it was asthma as I no longer have the lung power to wheeze properly!
    All my own fault.
    This little baby http://www.screwfix.com/p/jsp-powercap-active-universal-plug-8hr-respiratory-protection-li-ion/71038 allows me to cut the grass and weeds in the ditch, or do DIY stuff around the house because it filters out dust and pollen. Unfortunately it can't reduce humidity.
    Anyway thanks for the info. I take it you're not an Englishman but your writing style is not like other Americans I have encountered.
    Reply
    • Soggy, the every other day is a techniques that's often used to help people get past some of the more difficult side effects of the med; however, I would suggest that you and your doc consider upping the dose so that you're getting the full dose now that you're accustomed to it. We do know that people who stay at the half dose don't do as well as people on the full one. Just sayin'........
      Reply
  • Thanks Jean. I'll find out if my doctor thinks this Roflumilast is suitable for me, and if it is I will take the full dose to start with.
    Reply

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