Written by:
SVP and Head of Research and Early Development, Respiratory and Immunology, AstraZeneca
Director of Research and Innovation, Asthma and Lung UK
The importance of longitudinal patient cohorts in respiratory research
Radically improving the lives of millions of people around the world demands that we transform our understanding of respiratory disease. There are approximately 545 million people with a respiratory disease globally1. Diseases such as asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis have seen scientific advances, with research digging deep into the biology of these complex, chronic conditions. Healthcare systems are committing to improving outcomes for patients, however, there is still much to be done. Treatment for respiratory disease remains largely focused on symptom control with very little data collected from patients to understand their individual biology and disease progression.
If we are to move from a one-size-fits-all approach to treatment and instead, match the right patient to the right treatment at the right time we need to better understand the drivers of these diseases. Establishing patient cohorts - groups of individuals who have the same disease characteristics in common and who are studied over a period of time - would enable us to build comprehensive biomedical databases, or biobanks, of clinical and molecular data from patients. It is our belief that these molecular insights will uncover new drug targets and biomarkers to fuel the next wave of life-changing medicines for the patients who need them most.
Respiratory disease is the third biggest cause of death in the UK and impacts the lives of hundreds of millions of children and adults across the world. The respiratory community is united on the need for greater investment in research that can transform our understanding of these complex diseases and drive the development of new treatments, and ultimately cures.
Having been inspired by the success of developing patient cohorts in oncology to uncover new disease insights, it is clear that extending this expertise into respiratory diseases would allow patient-based research to become a core part of the healthcare environment. Partnerships between academia and industry have developed clinical cohorts that enable the identification of patient subgroups based on their disease markers and have been utilised to investigate the efficacy and safety of potential medicines. Global access to genetic patient banks has allowed scientists to uncover both rare and common variants across different populations and geographies, to drive precision medicine research and include respiratory patients in clinical trials with the right medicine for their underlying disease.
In our experience, these cohorts of a few hundred patients can be highly informative especially when they are connected to long-term health records that map out comorbidities, outcomes and treatment pathways in relation to an individual’s biomarkers. But we also know that cohorts of a few thousand patients could be transformative to respiratory research. Larger populations of patients monitored over the course of their disease could help identify different subpopulations with greater significance and match molecular biology with disease progression. In the wake of the pandemic, the UK Government along with governments from across the world are prioritising the improvement of respiratory research and care and, as a community, we have the opportunity to come together and deliver on the promise of transformation. Now is the time to drive research and innovation by joining together vast datasets, exploring the use of national lung screening programmes and expanding our knowledge on underlying disease drivers to establish improved methods of diagnosis, treatment and management and look to prevent the decline of lung function.
To better understand the genetic and molecular causes of chronic diseases, we need to share knowledge within the research community to gain better disease insight to provide greater benefits for patients. If we can successfully leverage data from patient cohorts to break down complex diseases into more focused patient subsets we may be better placed to quickly identify patients particularly at risk, as well as those more likely to respond to a particular treatment approach
In July 2021, the UK Government prioritised respiratory disease as one of its seven healthcare missions in its Life Sciences Vision opening up a platform to build a world-leading environment for respiratory research by connecting datasets and creating longitudinal patient cohorts. Additional programs, like Our Future Health, the UK’s largest ever health research programme, are building vast datasets of information across multiple diseases and this holds huge promise to be utilised to support health research in respiratory diseases and enable future discoveries.
Respiratory Disease is a significant driver of morbidity and mortality in the UK and globally. The Government is determined to bring to bear our world-class research infrastructure; ability to test, trial and deliver technology at scale in the NHS; and harness the innovation and drive of the private sector, to improve outcomes for patients
To achieve our ambition of revolutionising respiratory patient care and the respiratory life sciences, the key will be powerful data and clear evidence that is worthwhile to researchers, healthcare systems and patients. We are committed to working collaboratively with academics, government and healthcare bodies, patient organisations and industry to mobilise ourselves, as a community, to deliver unprecedented breakthroughs in the treatment of devastating respiratory conditions.
