Smoking gives Star Trek star Leonard Nimoy lung disease COPD

Leonard Nimoy has revealed he is suffering with lung disease. The 82-year-old shot to fame as Mr Spock in the original Star Trek series (1966-1969), before reprising the character in multiple television series and films and even turned his hand to directing for the films Search for Spock and Voyage Home.

The actor revealed to his 808,000 Twitter followers that even though he quit smoking 30 years ago, he has been left to fight the potentially fatal lung disease chronic obstructive pulmonary disease (COPD). Nimoy warned his thousands of followers to “quit now” before it is too late.

He warned: “I quit smoking 30 years ago. Not soon enough. I have COPD. Grandpa says, quit now!! LLAP [Long Live and Prosper].”

Viewers last saw Nimoy on screen as Mr Spock in the 2013 film Star Trek Into Darkness, playing the elder Spock and is the only member of the original cast to feature in the latest films from director JJ Abrams.

He sparked fears for his health after being pictured last month looking frail whilst pushed out of a New York hospital in a wheelchair, attached to a breathing apparatus.

Nimoy retired from attending Star Trek conventions back in 2011 but still engages with his fans on a regular basis, recently urging them to watch a scheduled marathon of Star Trek shows being shown on US television. Leonard said: “Trek Fest coming to EPIX on 2/16. I’ll be there. Join me.”

You may be wondering what exactly the condition is that Nimoy has. COPD is an umbrella term that spans a number of lung conditions such as chronic bronchitis, chronic obstructive airways disease and emphysema. People who have COPD have difficulties with their breathing due to their airways becoming narrower from damage to air sacs and passages to the lungs.

The primary cause for COPD is smoking, with the risk greatly increasing the more cigarettes you smoke and how long you have been smoking for.

It is believed there are more than 3 million who have the disease in the UK alone, but many dismiss their symptoms as merely a ‘smoker’s cough’ and as such, do not get medical help they need; only around 900,000 people have been formally diagnosed.

For those already diagnosed with COPD, stopping smoking is absolutely imperative and will ease their symptoms considerably. Although damage to the airways is irreversible, quitting smoking can slow down the speed at which the condition worsens.

In addition, many with COPD are prescribed a short-acting bronchodilator inhaler such as a beta-2 agonist like salbutamol, to be used when you start to feel breathless and easing the symptoms. If this type of inhaler is not sufficient, you may be instead prescribed a long-acting bronchodilator inhaler, whereby each dose lasts for 12 hours.

COPD drug could be used to treat asthma patients

Patients with poorly controlled asthma are a step closer to a new treatment option, after Phase III data showed that Boehringer Ingelheim’s lung drug Tiotropium, significantly reduced exacerbations and improved both lung function and quality of life.

The phase III research, presented at the European Respiratory Society conference in Vienna, also showed adding the once daily drug could cut the risk of any asthma exacerbation by 31%.

Tiotropium, a long-acting inhaled bronchodilator commonly used to treat chronic obstructive pulmonary disease (COPD), is currently unlicensed for treating asthma.

Spiriva, which is known chemically as Tiotropium is delivered by the Respimat Soft Mist inhaler. The research was published in the New England Journal of Medicine. Tiotropium has comprehensive clinical trial data, demonstrating an extensive wealth of experience since its introduction almost 10 years ago and over 25million patient years of real life experience, to support the efficacy and safety profile.

However, there remain concerns over the drug’s risk in patients with heart disease. Last year an analysis published by the British Medical Journal, found that the use of Spiriva delivered in a mist form (via Respimat), was linked with a 52% increase in the risk of death.

Boehringer Ingelheim said, “It did not agree with the authors conclusion that there is an increased mortality risk for Spiriva Respimat in COPD, and that its risks and benefits were included in its label.”

The German drug maker went on to say, “There were also significant improvements in lung function, asthma control and asthma related quality of life, lending further weight to the case for its use in controlling the disease. The need for new and effective asthma treatments is great, because a significant proportion of patients remain symptomatic and may experience asthma exacerbations, despite current therapies.”

In two trials supported by the drug’s marketers, Boehringer Ingelheim and Pfizer, researchers recruited 912 patients with asthma already taking inhaled glucocorticoids and long-acting beta-agonists (LABAs).

Despite their drug regimen, all patients remained symptomatic and had at least one severe exacerbation within the past year. Researchers randomised these patients to receive either Tiotropium once daily or placebo alongside their usual treatment. These were administered using a soft mist inhaler.

The team found that after 24 weeks patients receiving Tiotropium went on average 282 days without a first exacerbation, 21% longer than those on placebo, who experienced an exacerbation within an average of 226 days. The effects were sustained over 24 hours. Adverse events were similar between treatment and placebo groups.

The researchers concluded that, “In patients with poorly controlled asthma despite treatment with inhaled glucocorticoids and LABAs, adding Tiotropium significantly reduced the risk of episodes of the worsening of asthma and asthma exacerbations, requiring treatment with systemic glucocorticoids and provided sustained bronchodilation.”

Could a ‘Virtual Doctor’ improve patient care and save money?

For many elderly patients particularly ones suffering from diseases such as chronic obstructive pulmonary disease (COPD), heart disease or diabetes, getting to the doctors can be an ordeal.

Such patients need to have their vital signs and other parameters regularly monitored in order to effectively control and treat their conditions. However such patients may only see their doctor or nurse for such checks every few months, and if there is a problem in between then often they will have to be admitted to hospital.

However there is now a programme called Telehealth that has been in development since 2007, and is now being trialed by the North Yorkshireand York Primary Care Trust, using 500 patients suffering from diseases such as COPD, heart disease and diabetes.

The equipment called a Telestation is placed in a patient’s home and can monitor key readings from a patient within just five minutes every morning. The equipment has an integral scale to weigh the patient, a blood pressure cuff to take blood pressure readings, a pulse oximeter to measure pulse and blood oxygen levels, a glucose meter to measure blood sugar levels and even has a video camera built in so the doctor/nurse can physically see the patient if the need arises.

The really clever part of the Telehealth system is that the Telestation wirelessly transmits the readings once taken, to the patient’s phone line where they are transmitted directly to the Telehealth central control, where their own dedicated Telehealth nurse will daily review the readings.

The machine verbally takes the patient step by step throughout the five minute checkup and will also ask pre-set questions as well as taking various readings. If any of the readings fall outside of the pre-set parameters, an alarm will be triggered and the patient will immediately be contacted by their own dedicated Telehealth nurse.

Vera who is 71 and is suffering from COPD was initially skeptical about the scheme, but after taking part in the year long trial Vera claimed that the Telehealth system is “the best thing since sliced bread and that they should be in everybody’s home.” Normally patients suffering from COPD can easily be susceptible to infections that though may be easy to treat, often escalate into much larger problems necessitating hospital admission. The reason for this is that often patients leave it too late to get help, however with the Telehealth system the infection can be nipped in the bud by early diagnosis and treatment. Patients such as Vera suffering from COPD are given medication rescue packs containing antibiotics and steroids that can be taken as soon as needed after a consultation with their Telehealth nurse.

Telehealth nurse Dawn Watson who looks after Vera, tells how by working remotely she can look after more than 200 patients instead of the normal caseload of closer to 30 patients. As well as improved patient care the Telehealth system could obviously cut costs for the NHS especially when you consider that seven out of ten hospital beds are occupied by patients with long term conditions like Vera’s.

Paul Burstow, the minister for care services, claimed at a conference in March that “Telehealth could save the NHS up to £1.2 billion by 2014.” That claim seems to be well backed up as the trial which claims to be a success was launched in 2007, cost £30million, lasted three and a half years and was one of the most complex trials ever carried out by the NHS.

However the jury is still out on whether the Telehealth system is capable of saving the amount of money claimed, and also whether it can provide the improved patient care it claims. The reason the jury is still out on this is that the data analysis is being carried out by five academic institutions, and that for the findings to be both credible and useful, the academic analysis needs to be peer reviewed (a vital process of evaluation by independent experts.)