Early COPD Diagnosis Could save Billions of Kronor

If 600,000 Swedish patients with chronic obstructive pulmonary disease (COPD) had received their diagnoses two years earlier, it could have saved more than SEK 15 billion in direct healthcare costs during the first two years after diagnosis. This is shown by research results from the ARCTIC study, conducted by researchers at Uppsala University and Karolinska Institutet. These results were presented at the Nordic Lung Congress in Visby, Gotland.

intestinal tumours, molecular scissors, disease, genetic, immune cells, drug development, Diabetes, Antibiotic, hydrogen generation, chronic obstructive pulmonary disease, malaria, photosynthesis, kidney failure, Brain tumours, mental health, blood cancer, cancer, dementia, cancer treatment, antibiotic resistance, blood vessel leakage, quantum simulations, atrial fibrillation, batteries, goiter treatment, terahertz radiation, organic materials , Guild of European Research Intensive Universities, gene copies, social anxiety, blue light screens, ‘Our hope is that these findings will make it possible to discover a way to selectively inhibit the TGF-beta signals that stimulate tumour development without knocking out the signals that inhibit tumour development, and that this can eventually be used in the fight against cancer,’ says Eleftheria Vasilaki, postdoctoral researcher at Ludwig Institute for Cancer Research at Uppsala University and lead author of the study. TGF-beta regulates cell growth and specialisation, in particular during foetal development. In the context of tumour development, TGF-beta has a complicated role. Initially, it inhibits tumour formation because it inhibits cell division and stimulates cell death. At a late stage of tumour development, however, TGF-beta stimulates proliferation and metastasis of tumour cells and thereby accelerates tumour formation. TGF-beta’s signalling mechanisms and role in tumour development have been studied at the Ludwig Institute for Cancer Research at Uppsala University for the past 30 years. Recent discoveries at the Institute, now published in the current study in Science Signaling, explain part of the mechanism by which TGF-beta switches from suppressing to enhancing tumour development. Uppsala researchers, in collaboration with a Japanese research team, discovered that TGF-beta along with the oncoprotein Ras, which is often activated in tumours, affects members of the p53 family. The p53 protein plays a key role in regulating tumour development and is often altered – mutated – in tumours. TGF-beta and Ras suppress the effect of mutated p53, thereby enhancing the effect of another member of the p53 family, namely delta-Np63, which in turn stimulates tumour development and metastasis.

The new findings reported in Visby thus indicate that, over a two-year period, early COPD diagnosis could save the public purse approximately SEK 25,000 per patient in direct healthcare costs compared with late COPD diagnosis.

“Earlier COPD diagnosis could save the country huge sums in healthcare costs. In our study, we’ve focused on savings that are achievable during the first two years after COPD has been diagnosed,” says Professor Christer Janson of Uppsala University, who contributed to the study.

Early diagnosis brings major advantages for patients during subsequent years, too, in the form of reduced risk of COPD worsening and fewer sequelae (complications), such as osteoporosis, arthritis, cardiovascular disease, cancer and mental illness. For the individual COPD patient, there are very large gains associated with early diagnosis.

Spirometry for more people a must

“Many COPD patients, unfortunately, believe they’re generally in poor physical shape and think that’s why they often get out of breath. But breathlessness can mean something much worse: that COPD is developing. Our study shows that the earlier the disease is detected, the better the scope for effective treatment and improved control of symptom development. This enables patients to lead more active lives without complications. The study shows a 60% lower risk of acute episodes of COPD becoming more severe with early diagnosis than with late. That’s why it’s crucial for the public and healthcare services to become more aware of the need for pulmonary function testing with spirometry as soon as people find they’re often getting breathless,” says Christer Janson.

Other findings from the study

  • People diagnosed with COPD cost healthcare services five times as much as the control group who did not have COPD.
  • People diagnosed with COPD had incomes half as high as those of the control group who did not have COPD.
  • COPD patients diagnosed early have a 60% lower risk of the disease worsening
  • Women with COPD are diagnosed later than men with COPD.

About the ARCTIC study

ARCTIC is one of the largest studies on COPD patients conducted in Sweden. The study is based on the electronic medical records (EMRs) of 17,545 COPD patients and 84,514 reference patients. ARCTIC comprises three different studies: one that focuses on the value of early vs. late COPD detection; one that investigates the complications associated with a COPD diagnosis; and, last, a study that has quantified the economic implications of COPD. Investigations of this kind are feasible since EMRs have been  used in Swedish healthcare for many years. The results  of the study were presented at the 48th Nordic Lung Congress in Visby on 10–12 May 2017.

The study was supported by Novartis.

Source : Uppsala University