Increased prevalence of chest diseases in the Middle East place significant burdens on healthcare systems

Beirut, Lebanon: At its 4th Regional Thoracic Medicine Forum, which was held recently in the United Arab Emirates (UAE), Boehringer Ingelheim, one of the world’s leading pharmaceutical companies brought together over 150 of the region’s top pulmonologists to shed light on continued innovation in respiratory care.

At the event, experts have mentioned that the region as a whole has witnessed an increase in pulmonary diseases due to risk factors which include smoking, extreme weather variations, as well as genetic conditions. The prevalence of smoking and obesity has also reached alarming heights and the associated lung diseases present a major health burden to medical systems. 

The forum served as a platform to highlight the diagnosis and misdiagnosis as well as challenges towards controlling the prevalence of pulmonary diseases across the region that include asthma, chronic obstructive pulmonary disease (COPD) as well as Idiopathic pulmonary fibrosis (IPF).  In addition, healthcare professionals from the region also stressed the importance of early detection of the symptoms and proper adherence to treatment protocols.

Dr. Wajdi Abi Saleh – Associate Professor – Head of Division at Lebanese University and Clemenceau Medical Center said, “COPD is a chronic disease that causes limitations in lung airflow and the fourth leading cause of death worldwide, and is expected to become the third leading cause by 2030. 1 The current rate of COPD prevalence in Lebanon is high, with 80% of the cases are misdiagnosed.2 The most common symptoms are breathlessness and a chronic cough.  Although COPD is not curable, it is preventable; where treatment can help slow down the progression of the disease. Data from the landmark 52-week DYNAGITO® trial, involving more than 7,800 people with COPD, showed a lowered rate of moderate-to-severe exacerbations know as flare-ups after the trial. This important trial sheds light on the central role in managing COPD which can help reduce symptoms and minimizing the future risk of exacerbations.’’

People who have a family history of COPD are also more likely to develop the disease if they smoke. 3 In addition, long-term exposure to other lung irritants also is a risk factor for COPD such as air pollution, chemical fumes and dusts from the environment or workplace. 4

Dr. Abi Saleh also noted that, “With more and more exposure to environmental and occupational factors, the risk of contracting pulmonary diseases such as COPD among the general population is high. Smokers, usually visit the doctor complaining from heart problems and are unaware of what COPD is. It is important to take into account that not only is early detection important, but also the form of treatment, as well as the training required for doctors and hospitals to deliver the best care possible for those who are affected by COPD.”

In addition, experts at the forum shed light on the impact of asthma in the region. They said that the disease is not properly controlled and requires immediate action especially to increase awareness and overall understanding of chronic pulmonary diseases amongst patients, healthcare providers and governments. The number of people suffering from asthma across the world estimated to be as high as 334 million5. Asthma is not just a public health problem for high income countries: it occurs in all countries regardless of level of development. Over 80% of asthma deaths occurs in low and lower-middle income countries. 6

 “The burden of asthma in Lebanon and the extent to which guidelines are being followed for optimum asthma control are largely unknown. There are no reliable data on the prevalence of asthma in Lebanon to date, but according to studies, the prevalence of asthma among school children in the country have shown that the prevalence of the disease is 14%7. Asthma diagnosis requires the presence of more than one of the respiratory symptoms, worsening of the symptoms at night and exacerbation of the symptoms by viral infection, exercise, allergens, changing weather or smoke, Abi Saleh said.8

“The disease can cause a considerable burden on the physical, social, and professional lives of affected individuals and family. According to the International Study of Asthma and Allergies in Childhood (ISAAC) and the European Community Respiratory Health Survey (ECRHS), there has been an increase in the general prevalence of asthma. Although the prevalence of the disease is more in developed countries, evidence in recent years has shown a sharp increase in developing countries due to the impact of urbanization’’ added Dr. Abi Saleh.9

Doctors also highlighted the region’s increased prevalence of Idiopathic pulmonary fibrosis (IPF), a chronic and rare disease which is characterized by a progressive decline in lung function.

Moreover, Dr. George Dabar, Pulmonologist and Critical Care Physician at the Hotel Die de France Hospital in Beirut said, “The lungs of a patient with IPF, over time builds up with scar tissue which is called fibrosis. This causes the lungs to become stiffer and lose their elasticity and so the lungs become heavy and incapable to drive air in. On the other hand, the scaring prevents oxygen from going through the lung and diffuse into the blood. Most patients diagnosed with this disease are likely to die as a result of complications such as infections, respiratory or heart failure.10 The prognosis of IPF is worse than many forms of cancer- the 5-year survival rate with IPF is 20–40%. Symptoms of IPF are similar to other pulmonary diseases such as COPD and asthma which includes shortness of breath and chronic cough and so most patients are often misdiagnosed11. Proper diagnosis requires a set of diagnostic tests and it can take between one and two years from initial to diagnosis. In Lebanon, the prevalence of IPF stands at 0.002% of the total populations. Early diagnosis and treatment of IPF remains a critical unmet need that needs an action, because acting quickly can make a difference12. Currently there are available medications that can prevent the IPF disease from progressing.”

Dr. Dalia Mahmoud Amr, Medical Lead, Middle East, Turkey and Africa (META) at Boehringer Ingelheim, said, “This year saw another successful edition of the Boehringer Ingelheim Regional Thoracic Medicine Forum, which aims to address ongoing issues pertaining to pulmonary conditions and provides a platform for experts from around the region to exchange knowledge and explore a holistic approach to the treatment of COPD, asthma and IPF. Research and development has been the cornerstone of Boehringer Ingelheim's success and continues to be the major driver of innovative new approaches that help improve patient’s lives and address unmet therapeutic needs; in line with both national healthcare initiatives and systems.’’

The two day event comprised of interactive sessions with the overall goal for experts coming together to discuss the latest medical and scientific insights on treatment and management of pulmonary diseases across the META region.  Doctors agreed that there is still an urgent need to raise awareness among patients and inform doctors about respiratory illnesses, ensuring optimal diagnosis and recommendations around the right method of managing the burden of such diseases.

About Boehringer Ingelheim

Improving the health and quality of life of patients is the goal of the research-driven pharmaceutical company Boehringer Ingelheim. The focus in doing so is on diseases for which no satisfactory treatment option exists to date. The company therefore concentrates on developing innovative therapies that can extend patients’ lives. In animal health, Boehringer Ingelheim stands for advanced prevention.

Family-owned since it was established in 1885, Boehringer Ingelheim is one of the pharmaceutical industry’s top 20 companies. Some 50,000 employees create value through innovation daily for the three business areas human pharmaceuticals, animal health and biopharmaceuticals. In 2017, Boehringer Ingelheim achieved net sales of nearly 18.1 billion euros. R&D expenditure, exceeding three billion euros, corresponded to 17.0 per cent of net sales.

As a family-owned company, Boehringer Ingelheim plans in generations and focuses on long-term success, rather than short-term profit. The company therefore aims at organic growth from its own resources with simultaneous openness to partnerships and strategic alliances in research. In everything it does, Boehringer Ingelheim naturally adopts responsibility towards mankind and the environment.

More information about Boehringer Ingelheim can be found on www.boehringer-ingelheim.com or in our annual report: http://annualreport.boehringer-ingelheim.com. 

1 What is COPD? http://www.who.int/respiratory/copd/en/

2 Chronic obstructive pulmonary disease prevalence in Lebanon: a cross-sectional descriptive study | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257901/

3 COPD I https://www.nhlbi.nih.gov/health-topics/copd

4 COPD I https://www.nhlbi.nih.gov/health-topics/copd

5 Global Asthma Report http://www.globalasthmareport.org/resources/Global_Asthma_Report_2014.pdf

6 WHO | Asthma| http://www.who.int/respiratory/asthma/en/

7 Prevalence of asthma and asthma symptoms in children in urban Lebanon | https://www.researchgate.net/publication/297903310_Prevalence_of_asthma_and_asthma_symptoms_in_children_in_urban_Lebanon

8 https://onlinelibrary.wiley.com/doi/full/10.1111/crj.12655

9 Asthma Insights and Reality in the UAE | https://www.researchgate.net/publication/47567126_Asthma_insights_and_reality_in_the_United_Arab_Emirates

10 British Lung Foundation | What is IPF https://www.blf.org.uk/support-for-you/idiopathic-pulmonary-fibrosis-ipf/what-is-it

11 Idiopathic Pulmonary Fibrosis Symptoms, Causes, Treatment, and Life Expectancy I https://www.medicinenet.com/idiopathic_pulmonary_fibrosis_ipf/article.htm

12 Ley B, Collard HR, King TE. Clinical course and prediction of survival in idiopathic pulmonary -brosis.

Am J Respir Crit Care Med. 2011;183(4):431-40.

© Press Release 2018