Drug May Boost Breathing

F L O R E N C E, Italy, Sept. 3, 2000 -- An experimental drug could make breathingmuch easier for millions of people suffering from “smoker’slung,” new research suggests.

In tests involving 500 people who had suffered from chronicobstructive pulmonary disease for more than a decade, the drugappeared to be safer and better at improving breathing and atreducing infections and hospital visits than the best currenttreatment, researchers said. They were addressing scientists at theWorld Congress on Lung Health, which concluded Saturday.

On Market in 2002?

The inhaled drug, Spiriva, could be available as soon as 2002.And if it turns out to be as good as it looks right now, it couldimprove the quality of life for nearly half of the 600 millionpeople with the disease, said Dr. Bartolome Celli. Celli is chiefof pulmonary and critical care at St. Elizabeth’s Hospital inBoston and a leading authority on the illness.

While the drug probably will not slow the deterioration of thelungs, many sufferers could see their overall well-being improve bybetween 30 and 50 percent, said Celli, who was not involved in theresearch.

“The overall effect is something that almost has never beenseen,” said Dr. Romain Pauwels, a professor of medicine at theUniversity of Ghent in Belgium who conducted some of the research.“Compared to what we have now, this is far better, no matter whatparameter you’re measuring.”

Chronic obstructive pulmonary disease, known as COPD or“smoker’s lung,” is an irreversible progressive illness caused bynarrowing of the airways. It encompasses emphysema and chronicbronchitis.

Deadly Results

About 3 million people worldwide die from it every year, theWorld Health Organization estimates. About 15 million Americanshave it, and about 100,000 of them die each year, according to theAmerican Lung Association.

Many people who suffer from moderate or severe smoker’s lungcomplain of breathlessness so serious that they have to stop whengetting washed or dressed, they walk more slowly than others theirage and they cannot leave their homes to go shopping. The new drugrelieved those symptoms and also let sufferers perform simpleactivities like bending over without becoming short of breath, saidDr. Paul Jones, a professor of respiratory medicine at St. George’sHospital Medical School in London.

“That’s a very important thing,” said Jones, who did notconduct any of the research but designed the well-being standardsmeasured in the studies. “People laugh and snigger about gettingbreathless bending over, but bending over is very important formany activities—picking up things, putting on your socks—andit’s a major problem for patients with COPD. Most of them complainabout it.”

The new drug relaxes the muscles tightening the airways. It isrelated to the commonly prescribed inhaled medication Atrovent, butit targets the symptoms better and lasts longer, scientists say.

Another advantage is that the longer-acting drug, whose chemicalname is tiotropium, is inhaled once a day. Atrovent, oripratropium, has to be inhaled four times a day, and many patientssimply don’t take it as often as they should, Celli said.

‘Significant Step’

Both drugs are made by Germany’s Boehringer Ingelheim. Thecompany hosted a conference session at which two studies comparingthe drugs were presented.

“There is no doubt it is a significant step forward,” Jonessaid.

“Tiotropium caused an improvement in their health and that wasmaintained with very little evidence of deterioration over the nextyear,” he said. “That’s a really exciting, and an unexpected,finding. Those taking the short-acting drug were clearly gettingworse after the first three months of treatment.”

Even with the best treatment available, life is quite hard forthe type of patients in the studies—those who have moderate orsevere COPD, Jones said.

“In this study, 20 percent of the patients were houseboundbecause of their breathlessness, and that is pretty typical for thetype of patient in whom we’d be using this class of drug,” hesaid.

Boehringer Ingelheim said it plans to apply for Europeanapproval for the drug by the end of this year and for U.S. approvala year later. If accepted, it could be available by 2002.