Initial data from Hull collaboration project makes the case for nation-wide COPD diagnostic screening

• Results presented at the European Respiratory Society (ERS) Congress 2024 found that nearly 70% of people assessed through the FRONTIER project were diagnosed with chronic obstructive pulmonary disease (COPD) following a previous assessment via the Lung Health Check programme.^[1]
• Lung Health Checks can be an effective way of screening for lung diseases; however, COPD diagnostics were stopped during the COVID-19 pandemic and have not been reintroduced in many areas.^[2],[3]
• COPD is severely under-diagnosed with many patients only being diagnosed upon acute admission in emergency care settings.^[4]
• FRONTIER is a collaborative working project between Chiesi UK & Ireland and Hull University Teaching Hospitals NHS Trust (now part of NHS Humber Health Partnership).

Manchester, UK, 9^th September 2024 – Chiesi UK & Ireland and Hull University Teaching Hospitals NHS Trust have, today, announced initial findings from a collaborative working project highlighting that screening programmes provide a valuable opportunity to identify people living with undiagnosed COPD and could help to address COPD underdiagnosis by facilitating access to diagnostic testing.¹ The data, presented at the European Respiratory Society (ERS) Congress 2024 in Austria, forms interim analysis from FRONTIER, a collaborative project in Hull, in which patients previously assessed via the NHS Lung Health Check programme and with symptoms of lung disease and/or emphysema on CT scan were identified and invited back for COPD testing. The analysis showed that 136 (68%) of 201 individuals seen through the programme were diagnosed with COPD.¹

“Our early findings clearly highlight the burden of undiagnosed COPD among those attending the Lung Health Check programme in Hull,” said Professor Michael Crooks, Professor of Respiratory Medicine, Hull York Medical School, University of Hull. “Many of those diagnosed with COPD during FRONTIER were living with daily symptoms but had not been able to access treatment due to a lack of diagnosis. Identifying people attending Lung Health Checks that are at high risk of having undiagnosed COPD and offering diagnostic testing enables access to evidence-based COPD care that has potential to significantly improve health outcomes.”

An estimated two million people have undiagnosed COPD in the UK.⁴ More than half of those who have a moderate form of the disease go undiagnosed, and one in five of those who are undiagnosed have severe or very severe forms of the disease.⁴ COPD causes 115,000 emergency admissions per year and 24,000 deaths.⁴ FRONTIER is a collaborative working project between Chiesi UK & Ireland and Hull University Teaching Hospitals NHS Trust. It aims to enable early COPD diagnosis and timely initiation of interventions to improve outcomes for patients including pharmacological and non-pharmacological treatment.

Commencing in September 2023, and due to run until September 2025, FRONTIER seeks to invite approximately 1,000 previous Lung Health Check participants for COPD testing. Spirometry – the standard of care used to diagnose COPD – was previously included in Lung Health Checks but was stopped during the COVID-19 pandemic.³ These initial results reported the clinical characteristics and COPD diagnosis rate among the first 201 participants between October 2023 and January 2024.¹ Of the 136 (68%) who received a new COPD diagnosis, 77% had moderate emphysema, 12% had mild, 7% had none and 4% had severe.¹ The mean COPD assessment test (CAT) score was 16.7.¹

“These initial data tell a story of how a lack of COPD screening is playing out in the real world. With challenges in diagnosing COPD including lack of public awareness and engagement with healthcare professionals trained in respiratory diagnostics as well as common misdiagnoses, the value of screening for COPD is clear,” said Shish Patel, Medical Director, Chiesi UK & Ireland. “While chronic, COPD can be effectively managed, and the earlier it is diagnosed the greater the opportunity for intervention, whether that be lifestyle changes, rehabilitation or treatment. The FRONTIER project represents Chiesi’s commitment to improving the lives of people living with COPD, and we look forward to sharing the full outcomes of the collaboration with the community to inform planning for a nation-wide screening programme.”

The FRONTIER poster is one of three data readouts being presented by Chiesi UK & Ireland at the ERS Congress 2024. These include the presentation of patient insights from a qualitative research study into decentralisation of a clinical trial in asthma (TANGO) and the sharing of key developments in the company’s carbon minimal inhaler programme.^[5]

[1] Brindle K, Watkins K, Shyamalee J, Thompson J, Faruqi S, Gilroy-Cheetham J, Maxted C, Niazi-Ali S, Crooks M. Finding the hidden millions: identifying undiagnosed, symptomatic COPD through lung cancer screening (the FRONTIER Programme). Presented at European Respiratory Society (ERS) Congress 2024.

[2] Hull University Teaching Hospitals NHS Trust. Free NHS Targeted Lung Health Checks launches in East riding of Yorkshire. Available at https://www.hey.nhs.uk/news/2023/11/14/free-nhs-targeted-lung-health-checks-launches-in-east-riding-of-yorkshire. Last accessed September 2024.

[3] Bradley C, Alexandris P, Baldwin DR et al. Measuring spirometry in a lung cancer screening cohort highlights possible underdiagnosis and misdiagnosis of COPD. ERJ Open Res. 2023;9(4):00203-2023.

[4] NHS England. Overview of potential to reduce lives lost from Chronic Obstructive

Pulmonary Disease (COPD). Available at https://www.england.nhs.uk/wp-content/uploads/2014/02/rm-fs-6.pdf. Last accessed September 2024.

[5] Clinical Trials. Comparison Between CHF5993 pMDI 200/6/12,5mg HFA-152a VS CHF5993 pMDI 200/6/12,5mg HFA-134a in Subjects With Asthma (Trecos) (TRECOS). Available at https://clinicaltrials.gov/study/NCT06264674. Last accessed September 2024.