Chronic Obstructive Pulmonary Disease (COPD) is the second commonest non-infectious disease in the world. Prevalence rates worldwide are high particularly in low and middle income countries, with up to 64 million people affected.
COPD is predicted to be the third leading global cause of death by 2020, and is currently the sixth leading cause of death (three million per year). COPD is a prevalent problem in the Asia-Pacific region as there are still very high smoking rates, especially amongst males. Females however also have COPD because of their exposure to biomass fuel smoke. The total financial cost in 2008 of COPD was estimated to be $8.8bn: $6.8bn due to lower employment, absenteeism and premature death.
Other important respiratory diseases globally include lung cancer, asthma and tuberculosis.
Over the last 25 years, Australia has seen a dramatic drop in asthma mortality and a marked change in the frequency and severity of asthma episodes that require hospital admission, ICU treatment and assisted ventilation. This suggests that asthma treatment and self-management, clinician awareness and community responses are very much improved compared to 25 years ago.
Asthma prevalence in adults and children has fallen very slightly, and asthma now affects 10% of Australia’s population. Most asthma is mild, but many people have frequent symptoms, and do not take regular preventer medication, thus putting themselves at risk of permanent loss of lung function, persistent symptoms and acute attacks.
At The George, we are undertaking studies in Asia to assess new interventions to improve asthma and COPD outcomes. We are currently implementing a large clinical trial in China, testing affordable oral medications in combination, based on research that suggests that low doses of these treatments given together can achieve marked benefit in COPD. We are undertaking this 12 month study in over 50 centres in China, recruiting over 2000 patients.
We are testing a new concept with these two drugs which, if effective, has the potential for significant benefit as these are inexpensive drugs. We will be undertaking other studies in airways disease over the next one to two years.