Management of COPD in Asia: A position statement of the Asian Pacific Society of Respirology

Abstract

Chronic obstructive pulmonary disease (COPD) is a major disease in Asia. However, how to manage specifically Asian COPD patients has not been proposed. Awareness of COPD is very low and underdiagnosis/undertreatment is common in Asian countries. Low utilization of pulmonary function test and inhalers is also a problem. Moreover, high smoking prevalence and air pollution are barriers to managing Asian patients with COPD. The relatively low body mass index of Asian patients with COPD can increase their risk for experiencing adverse effects from COPD drugs. Physicians should consider the unique features of Asian populations with COPD such as the high prevalence rates of bronchiectasis and tuberculosis‐destroyed lungs, biomass smoke exposure and parasitic infection.

Role of phosphodiesterase-4 inhibitors in chronic obstructive pulmonary disease

“…Enrollment criteria in that study did not match the current indications for roflumilast. No Asian patients participated in this 250-μg trial, although the BMI of Asian COPD patients is usually much lower [39][40][41]. The pharmacokinetics of this drug are related to BMI.…”

Contemporary Concise Review 2019: Chronic obstructive pulmonary disease

“…Over the past 20 years, there has been a tremendous progress in COPD management. However, as pointed out by Rhee et al ., most of these recommendations have been generated from data arising from North America and Western Europe; thus, these data may not be fully applicable to the Asian populations . For instance, bronchiectasis and post‐tuberculous lung diseases are common in Asia (especially southeast Asia) and thus many Asian COPD patients may also have these conditions.…”

“…However, as pointed out by Rhee et al, most of these recommendations have been generated from data arising from North America and Western Europe; thus, these data may not be fully applicable to the Asian populations. 19 For instance, bronchiectasis and post-tuberculous lung diseases are common in Asia (especially southeast Asia) and thus many Asian COPD patients may also have these conditions. The presence of these pulmonary comorbidities may impact therapeutic choices as inhaled corticosteroids may increase the risk of pneumonia and reactivation of tuberculosis.…”

Determinants of Clinical COPD Questionnaire in Patients with COPD: A Cross-Sectional Observational Study

“…Chinese patients with COPD have unique features compared with those from Western countries. Generally, they had lower BMI and more severe airflow limitation and experienced more exacerbations [12][13][14][15][16][17]. This is probably due to the delayed diagnosis and intervention for COPD in China [18].…”