Patients with Chronic Obstructive Pulmonary Disease (COPD) have to deal with up to 4 exacerbations per year. These seizures often lead to hospitalizations, and they involve not only suffering but real risk. If you have suffered from recurrent exacerbations of COPD or other symptoms that impair your quality of life – it is possible that clinical research can give you access to innovative treatments free of charge.
It is estimated that in Israel there are no less than 100,000 COPD patients – who are dealing with severe symptoms. In practice, it is possible that the numbers are even higher.
The increasing incidence of the disease – together with the fact that it is chronic, i.e. incurable – has led, in recent years, to become the third most common cause of mortality.
These are worrying data. For many patients, COPD treatment “pursues” symptom control. Exacerbations occur almost on an annual basis, and sometimes even more, with daily shortness of breath becoming more severe or with increasing frequency or severity of the cough. The ability to prevent the disease from deteriorating is limited and includes, among other things, smoking cessation, respiratory rehabilitation, and various combinations of pharmacological treatments.
As a COPD patient, your daily life can be difficult to manage. Between the inhalers and the pills, between the shortness of breath that also limits simple efforts to phlegmatic coughs – you may just feel that your disease is not under control.
Although there are over 400,000 COPD cases in Israel, it is estimated that many COPD cases are undiagnosed.
It is now estimated that 10% of all people over the age of 40 suffer from COPD.
There is often an overlap between the diagnosis of COPD and other lung diseases, including asthma.
COPD treatment relies on drug therapy combined with respiratory rehabilitation and smoking cessation.
Severe cases of COPD can lead to surgery to reduce lung volumes, and even to a lung transplant.
The increasing incidence of the disease – together with the fact that it is chronic, i.e. incurable – has led to it in recent years becoming the third most common cause of mortality. – What are my Options?
The vast majority of COPD cases occur following long-term smoking. The main symptoms of the disease – shortness of breath, persistent cough and phlegm – often require a verification by a pneumologist.
The diagnosis itself relies on a lung function test called spirometry. This test predicts the expected lung function value for a person of your age and compares it to your actual lung function. The smaller the ratio between the actual function and the expected function is, the less good your lung functions are.
Spirometry is used not only for diagnosis but also for monitoring and rating the severity of the disease. It helps the doctor to choose the appropriate treatment according a mild, moderate or severe illness. Today, the severity rating of the disease also relies on medical questionnaires designed to assess how you – the patient – experience the disease: how severe the symptoms are, how many exacerbations you experience per year, or whether there are any associate chronic diseases.
Pros and Cons.
Most patients with COPD begin with conservative treatments. These treatments include smoking cessation, vaccinations against respiratory infections (flu and the pneumococcal bacterium that causes pneumonia), and respiratory rehabilitation. This is in fact the therapeutic basis, however when it is not sufficient it is customary to add inhaled therapy as well.
The inhalers usually contain substances with long-term activity aimed at dilating the bronchi. Some inhalers also contain steroids.
Already in these treatments there are patients who have difficulties – some have difficulty using inhalers, others suffer from side effects such as the appearance of fungus in the mouth (Candida) due to prolonged inhalation of steroids.
A small proportion of patients may not respond to inhalers and require more comprehensive medication. These patients usually suffer from a large number of exacerbation a year (over two, or a severe exacerbation that requires hospitalization). Some will be treated with antibiotics for a long time or with drugs such as roflumilast (known under the trade name Deliresp®).
These drugs can prevent exacerbations, but unfortunately they do not always improve the course of the disease itself. Also, these treatments can have difficult side effects.
In cases of severe shortness of breath accompanied by low oxygen levels, patients with COPD also use a home oxygen generator and sometimes a non-invasive ventilator (such as a BPAP device) to help them better ventilate their lungs. Patients do not always adhere to these non-invasive treatments. You may have experimented with oxygen glasses or a BPAP mask yourself and experienced improvement, but you may also have found them bothersome and cumbersome for daily conduct.
In particularly severe cases, where the lifestyle has been significantly impaired and all treatment lines have been exhausted, some patients are referred for surgical evaluation. In some cases, surgery can be performed to reduce the volume of the lung – in which part of the lung that is affected by the disease is excised; In particularly severe cases a lung transplant is needed.
Lung function tests are used not only for diagnosis but also for monitoring and rating the severity of the disease. They help the doctor choose the appropriate treatment for a mild, moderate or severe illness.
After exhausting all the treatment lines – what is the next step?
Quite a few patients with COPD do not feel that they have reached full benefit under their current treatment.
Many patients have difficulty with the variety of medications and inhalers that must be used daily to “take control” of the disease. This is especially true for patients who suffer from comorbidities and are taking other treatments as well.
More importantly, no treatment is currently available as a treatment that cures the disease. Treatments today focus on reducing exacerbations and controlling symptoms, but not all patients experience an improvement in their quality of life.
To meet all of these needs, clinical trials are being conducted to treat COPD. These studies examine new drugs, new combinations or technologies that have not yet been tried to lead to a significant improvement in coping with the disease.
Clinical trials examine new drugs, new combinations or technologies that have not yet been tried to lead to a significant improvement in coping with the disease. – I want to check my eligibility to one of them here.
Clinical studies in Israel for COPD
In Israel, a number of studies are currently being conducted for patients with COPD with different degrees of severity. the aim of the treatments being tested is both, cure the disease and to improve the symptoms of the disease for a better quality of life, in a better way than what is achieved with current treatments.
The treatments are performed in many medical centers in the country, under continuous medical supervision and free of charge.
To better understand what clinical trials mean and how they are conducted, visit our dedicated page.
How can you tell if there is a clinical study that is right for you?
As a COPD patient, you can fill out our questionnaire here. The purpose of the questionnaire is to understand the severity of your illness and to check whether you meet the criteria for participating in a clinical study that seeks a new and more effective treatment for your COPD.