Landmark Survey Reveals Respiratory Symptoms During Exercise Contribute to Poor Quality of Life in the U.S.

Monday, March 1, 2010 General News
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HORSHAM, Pa., March 1 For the vast majority of the general public, respiratory symptoms such as shortness of breath, wheezing or coughing are a common part of the exercise experience. However, together with chest tightness, noisy breathing and trouble taking a deep breath, these six symptoms make up the phenomenon known as exercise-induced bronchospasm (EIB), which has physical, emotional and psychological consequences if not addressed properly. The impact of EIB on the lives and health of the public was assessed in "EIB: A Landmark Survey," the first comprehensive national survey of the public, asthma patients and healthcare providers about exercise-related respiratory symptoms in the U.S. Findings from the survey were released by Teva Respiratory at the American Academy of Allergy Asthma & Immunology (AAAAI) Annual Meeting, held Feb. 26-March 2, 2010, in New Orleans, La.

For people with asthma, understanding the interaction between exercise and their asthma is critical for having a better quality of life. According to the survey, exercise and weather are the two strongest triggers of symptoms for people with asthma, and the experience of exercise-related symptoms is one of the reasons that people with asthma limit or even avoid activities. In fact, 46% of adults and 26% of children avoid activities that they would like to do because of their exercise-induced symptoms.

"Many people don't realize they have EIB because they think these are their body's normal responses to working out. Physical exertion may be the only thing that triggers your symptoms, and in the case of people diagnosed with asthma, it may be one of several triggers," says Timothy Craig, D.O., Professor of Medicine and Pediatrics, Penn State University College of Medicine. "But having EIB doesn't mean you should avoid exercise. Proper treatment and precautions can help you stay active - whether you're taking a leisurely walk or competing as a professional athlete."

In the survey, a full 82% of the asthma population reported experiencing at least one of the six symptoms during exercise, and 22% of asthma sufferers experience all six. Despite this high prevalence, a startling 78% of asthma patients have undiagnosed EIB. Similarly high figures were observed in the general population arm of the study, where 65% of the public (includes asthma sufferers) experienced at least one symptom during exercise and were not diagnosed with EIB. These findings underscore the need for increased awareness and education about EIB among the general population, and particularly for asthma patients for whom exercise seems to pose additional challenges. Currently, only 22% of asthma sufferers have heard of EIB, suggesting that there are many who have symptoms but are unaware of what they are experiencing, and are potentially unaware that there is an effective way to prevent exercise-related symptoms from occurring.

According to the National Heart, Lung and Blood Institute's (NHLBI) National Asthma Education and Prevention Program (NAEPP) guidelines, EIB can be prevented by using a short-acting beta-agonist (SABA) such as albuterol prior to vigorous activity or exercise. The preference for pre-treating with a SABA was validated in the healthcare provider sample of the survey, where SABAs were most often cited as the class of medication with the highest therapeutic yield for adults and children with exercise-related symptoms. Furthermore, healthcare providers were strongly aligned (averaging 73%) on when quick-relief medicines like SABAs should be used, which was clearly prior to beginning exercise. Interestingly, the survey revealed that only 29% of asthma patients with undiagnosed EIB also believed that SABAs should be used before exercise, with this population being far more likely to use their quick-relief inhaler after they exercise (45%). Even those asthma patients who have been diagnosed with EIB are not using their inhaler as recommended by NAEPP - 43% use a SABA before exercise, while 47% use their inhaler after exercise.

"These findings underscore the need for physicians to continue educating patients about how to properly use albuterol when it comes to the prevention of exercise-related respiratory symptoms, because it's different from their regular asthma routine," states Dr. Craig. "While patients are used to taking their quick-relief inhalers in response to flare-up of symptoms, when it comes to exercise, it is crucial that they learn to use it beforehand to prevent an attack from coming on," Dr. Craig added.

While pre-treatment with a SABA is what doctors recommend for managing EIB symptoms, patients who have frequent, severe EIB should talk to their physician to evaluate the status of their underlying asthma. There may be a need to initiate or increase daily long-term control therapy since symptoms of EIB for those with asthma can be a sign that their asthma is not well controlled.

"EIB: A Landmark Survey" provides a comprehensive look at the experience of exercise-related symptoms and the impact on the lives of patients. The survey also provides healthcare professionals with insight into the gaps in patients' understanding of their asthma, and can be used as a tool when discussing which albuterol inhaler design is right for them. For example, some albuterol inhalers can be stored or carried in any position, while others have special instructions which require them to be stored upright in order to function as intended. Education combined with the right treatment will help patients with EIB better incorporate exercise into their lives and keep them on the road to better health.

To learn more about "EIB: A Landmark Survey," stop by Booth #210 at the AAAAI Annual Meeting, or visit to download the full executive summary of results.

About EIB: A Landmark Survey

Exercise-Induced Bronchospasm "(EIB): A Landmark Survey" is the first comprehensive national survey of the public, asthma patients and healthcare providers about exercise-related respiratory symptoms in the U.S.

The survey included more than 3,000 interviews conducted between December 2009 and February 2010. A national sample of 1,001 adults and 516 children, aged 4 and older, who have been diagnosed with asthma and who have had asthma symptoms in the past 12 months or are taking medicine for their asthma, was interviewed by telephone about their condition and treatment. For comparison, a national sample of 1,085 adults was also interviewed. In addition, a national sample of 450 healthcare providers were interviewed as part of this survey to provide insights on the healthcare provider perspective of asthma management. "EIB: A Landmark Survey" was conducted by national public opinion research organization Abt SRBI Inc. in partnership with Strategic Pharma Solutions LLC and sponsored by Teva Respiratory.

About Asthma and Exercise-Induced Bronchospasm

Asthma is a chronic (long-term), treatable lung disease that causes inflammation and constriction of smooth muscle around the large and small airways (or bronchial tubes). When something sets off or triggers an asthma attack, like exercise, airways become inflamed and swollen, and the muscles around the airways tighten (bronchospasm). Symptoms of asthma include wheezing (a whistling sound when you breathe), chest tightness, shortness of breath and coughing that often occurs at night or early in the morning. Without appropriate treatment, asthma symptoms may become more severe and result in an asthma attack, which can lead to hospitalization and even death. If a person has exercise-induced bronchospasm (EIB), physical exertion may be the only thing that triggers asthma symptoms.

Asthma affects people of all ages, but it most often starts in childhood. In the U.S., more than 22 million people are known to have asthma, including more than 6 million children. Each year in the U.S., asthma causes approximately 500,000 hospitalizations, 134 million days of restricted activity and 4,000 deaths. It is estimated that 80 to 90 percent of all individuals who have allergic asthma will experience symptoms of EIB with vigorous exercise or activity. For teenagers and young adults, exercise is often the most common cause of asthma symptoms.

About Teva Respiratory

Teva Respiratory is the U.S.-based respiratory subsidiary of Teva Pharmaceutical Industries Ltd. Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 15 pharmaceutical companies in the world and is the leading generic pharmaceutical company. The company develops, manufactures and markets generic and innovative human pharmaceuticals and active pharmaceutical ingredients. Over 80 percent of Teva's sales are in North America and Europe.

Teva's Safe Harbor Statement under the U. S. Private Securities Litigation Reform Act of 1995:

This release contains forward-looking statements, including, among other things, regarding our expected profitable growth, revenues, net income, the drivers and contributors of this growth, strategy and competitive advantages, which express the current beliefs and expectations of management. Such statements are based on management's current beliefs and expectations and involve a number of known and unknown risks and uncertainties that could cause our future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to: our ability to successfully develop and commercialize additional pharmaceutical products, the introduction of competing generic equivalents, the extent to which we may obtain U.S. market exclusivity for certain of our new generic products and regulatory changes that may prevent us from utilizing exclusivity periods, potential liability for sales of generic products prior to a final resolution of outstanding patent litigation, including that relating to the generic versions of Neurontin®, Lotrel®, Protonix® and Eloxatin®, the current economic conditions, competition from brand-name companies that are under increased pressure to counter generic products, or competitors that seek to delay the introduction of generic products, the effects of competition on our innovative products, especially Copaxone® sales, including potential oral and generic competition for Copaxone®, dependence on the effectiveness of our patents and other protections for innovative products, the impact of consolidation of our distributors and customers, the impact of pharmaceutical industry regulation and pending legislation that could affect the pharmaceutical industry, our ability to achieve expected results though our innovative R&D efforts, the difficulty of predicting U.S. Food and Drug Administration, European Medicines Agency and other regulatory authority approvals, the uncertainty surrounding the legislative and regulatory pathway for the registration and approval of biotechnology-based products, the regulatory environment and changes in the health policies and structures of various countries, supply interruptions or delays that could result from the complex manufacturing of our products and our global supply chain, our ability to successfully identify, consummate and integrate acquisitions, the potential exposure to product liability claims to the extent not covered by insurance, our exposure to fluctuations in currency, exchange and interest rates, significant operations worldwide that may be adversely affected by terrorism, political or economical instability or major hostilities, our ability to enter into patent litigation settlements and the intensified scrutiny by the U.S. government, the termination or expiration of governmental programs and tax benefits, impairment of intangible assets and goodwill, environmental risks, and other factors that are discussed in this report and in our other filings with the U.S. Securities and Exchange Commission ("SEC").


SOURCE Teva Respiratory LLC, a subsidiary of Teva Pharmaceutical Industries Ltd.

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