Chronic obstructive pulmonary disease (COPD) is a slow progressive disease comprising chronic bronchitis and emphysema that is caused largely by smoking. Despite anti-smoking campaigns, COPD is the fastest growing major disease in the U.S. and around the world, and mortality rates continue to rise. Affecting nearly 13.5 million patients, it is now the third largest cause of mortality in the U.S. Approximately 1.8 million patients in the U.S. are diagnosed with severe to very severe COPD, while an additional 4.9 million are diagnosed with moderate COPD. Symptoms of COPD include severe cough, fatigue, upper respiratory infections, shortness of breath with increased activity levels (dyspnea) and wheezing.
Although there is no known cure for COPD, the disease is largely managed with inhaled bronchodilators and corticosteroids to improve lung function and reduce the frequency of exacerbations. Longer-acting agents and combinations have proven successful for treating the majority of COPD patients, but the sicker and older segment of the COPD population requiring nebulizer delivery are limited to shorter-acting agents and/or long treatment times. Spiriva® (tiotroprium), a long-acting muscarinic agent, is achieving the highest growth in patient volume, but physicians indicate that patients struggle to use the dry powder inhaler due to a combination of issues related to frailty, cognitive impairment and low inspiratory drive. Elevation Pharmaceuticals is developing the only long-acting agent that inhibits muscarinic receptors in the bronchial airways, which leads to muscle relaxation and improved lung function. The company is focused on developing EP-101 for these patients with the highest treatment burden in order to significantly improve their standard of care.