Can we personalize therapy for COPD patients in Canada?

Date posted: 
Thursday, April 13, 2017

Nearly 1.7 million Canadians suffer from chronic obstructive pulmonary disease (COPD).  It is primarily caused by the inhalation of lung toxins (such as air pollution and smoking) in genetically susceptible individuals and is characterized by a progressive decline in lung function resulting in shortness of breath, cough and sputum production.

The disease is responsible for 11,000 deaths, and more than 70,000 hospital admissions every year in Canada, making COPD the leading cause of hospitalization in the country. COPD-related costs nationally are estimated to be $3.94 billion per year and estimated to rise to $9.45B by 2030, driven largely by the aging of the population and expected increase in hospitalization rates over the next 20 years.

“Many COPD patients experience acute COPD exacerbations (AECOPD), during which their shortness of breath and cough worsen, leading in extreme cases to a state of “breathless paralysis”, says Dr Don Sin, Professor of Medicine at the University of British Columbia. “As there are no simple clinical tools to risk-stratify patients for AECOPD, patients are often over- or under-treated, resulting in suboptimal health outcomes, cost inefficiencies, and significant morbidity and mortality.”

Furthermore, because the symptoms of AECOPD overlap with those of heart attack, pulmonary embolism, heart failure, and others, efficient diagnosis and treatment of AECOPD is a major challenge for physicians, especially early in their course when symptoms are mild and non-specific. However, timely diagnosis of AECOPD and prompt initiation of treatment at this stage can prevent full-blown lung attacks.

The Genome Canada program is a collaborative effort aiming to improve the current situation by developing a simple, blood-based biomarker test to diagnose AECOPD early and to prognose AECOPDs. This will enable personalized therapy for COPD patients. Patients who need preventative drugs will receive them, preventing lung attacks and reducing hospitalizations and emergency visits, while patients at low risk of lung attacks will be able to avoid unnecessary drugs and their potential side effects.

Data access has been approved for a British Columbian sub-project of the Genome Canada program, led by Dr Sin, to be conducted at St. Paul’s Hospital and Vancouver General Hospital. Within this sub-project, following informed consent, bio-specimens and clinical data will be collected from a cohort of COPD patients who are hospitalized or stable. PopData will link  this researcher-collected data with administrative data from the BC Ministry of Health, BC Vital Statistics Agency data and the National Ambulatory Care Reporting System.

The Genome Canada program is funded by the Canadian Institutes of Health Research, Genome Canada, Genome BC, Genome Quebec, St Paul’s Hospital, Providence Health Care Research Institute and PROOF Centre of Excellence, a not-for-profit organization co‐hosted by the University of British Columbia and Providence Health Care.

Page last revised: April 13, 2017