COPD: Global Overview of the Clinical Research Landscape

Prevalence, Past Experience, and Competition


Chronic obstructive pulmonary disease (COPD) puts people who have the disease at a higher risk of developing heart disease and lung cancer as well, so finding the right treatment is very important for patients. 

This chronic inflammatory disease is usually caused by prolonged exposure to irritating gases or cigarette smoke. Emphysema and chronic bronchitis often contribute to the development of the disease. COPD gets progressively worse over time but with the right treatment, patients can have a high quality of life. 

COPD is most prevalent in Central and Eastern Europe, with Hungary and Bulgaria leading in prevalence. 

Of course, if we go simply by the number of patients, the biggest pool of patients is in China, followed by India, and the USA. Wondering how other countries rank? You can check on TrialHub.    

Countries with Past Experience in COPD Clinical Research

The way we usually measure the research experience of a given country is by calculating the number of trials performed per one million people. The map below shows, on a global level, which countries have had more clinical trials than others based on their population: 

The darkest red regions are the ones with the most previous experience in running studies in COPD. As you can see, Central and Eastern Europe, where the disease is most prevalent, are not among with the highest historical experience.

However, when we exclude Phase 4 and, if we only want to see trials conducted in the past 3 years, the map becomes more relevant to the current clinical research landscape:

Although a country with a high prevalence and 20 trial sites, Bulgaria has little experience in the past 3 years as well.  

However, if we look at the number of trials completed in general divided by the number of people who live there, then Bulgaria actually ranks 5th:

This is the case only for Phase 1-3 clinical trials in the past 3 years – historically, Hungary and Bulgaria as most prevalent countries rank 9th and 13th respectively. 

Interesting Note:

Among the 5,147 analyzed trials, we identified 223 trials that had a virtual component included in their design. 96 of those research studies are Treatment focused. You can find their details on TrialHub.

Countries with Active or Recruiting Clinical Trials

At the moment there are 1,772 active, recruiting, or not yet recruiting clinical trials. Of them, the ones currently recruiting patients are 883.   

The countries with the highest number of trials are Germany, China, UK, and USA. However, if we want to better measure the competition level when it comes to patient recruitment, it’s best to measure trials versus population. Based on trials per million people, the top 5 countries with the highest competition are as follows:

On the below map, you can also get a better idea of the global competition in running COPD clinical trials:

The dark green regions are the ones with less or no competitive trials.

As you can see on the map, in highly prevalent countries like Bulgaria and Hungary there is less competition and many unoccupied sites. This presents an opportunity to connect with local centers and partner on including their patients.

To learn more about such opportunities – including the Patient Pathway in a given country as well as Standard of Care – you can reach out to our team at

Recruitment Rates and Trials’ Performance Statistics 

We analyzed 3,317 clinical trials for their Recruitment Rates and assessed countries based on their Average Recruitment Rate (patients/ site/ month). The map below presents the regions with high ARR in dark yellow, ranging between 7.02 patients/site/month and 0.22 patients per site per month.

For Phase 3 studies only, ARR varies between 0.44 and 1.56 and for Phase 1 and 1/2 between 0.2 and 15.08 patients/site/month respectively. 

Looking at the highest recruiting countries, these are the top 5:

On the other end of the ranking, the countries that have the lowest ARR are:

All these rates are based on all sorts of research studies. If you’d like to know how the ranking changes for treatment-focused studies, you can log into TrialHub or get in touch with us to discuss your protocol:

Interesting Stats:

Here are some statistics on the planned vs. actual performance of COPD clinical trials:

COPD trials on average finished with 56% more sites than the ones they started with. This could be attributed to overestimating the ARR resulting in study delays. 

Sites and Investigators

At TrialHub, we have identified 3,998 research centers that have been working on clinical trials for COPD. You can see on the map how they are distributed. 2,269 of them have had at least one study focused on treatment.

Highlighted in red are the ones currently working on trials in COPD:

When it comes to research sites that are currently not involved with studies in this indication, out of 3,998, we identified that about ¾ are currently not occupied – 2,912. 

Below, we provide you with a list of  the most experienced organizations in COPD research in the countries with the highest number of trials per million people:

There are also many investigators with a background in COPD research where studies have been conducted. At TrialHub we identified 4,660 such investigators. 2,380 of them have experience in trials focused on researching treatments. 152 of these investigators have worked on Phase 1 and Phase 1/2 studies. 

Interesting Note:

The top 10 investigators with the most completed clinical trials in COPD are:

  • Donald A Mahler – USA, New Hampshire
  • Fernando J Martinez – USA, Michigan
  • Georg Nilius – Germany, NRW
  • Charles Fogarty – USA, South Carolina
  • Klaus Kenn Ext – Germany, Schönau am Königssee
  • Denis E O’donnell FRCPC – Canada, Ontario
  • Wilfried De Backer – Belgium, Antwerp
  • Gerard J Criner – United States, Pennsylvania

To learn more about them, and other investigators available to run clinical trials in COPD you can contact us at

TrialHub is a feasibility intelligence platform that supports feasibility, startup, patient recruitment and clinical project managers with a 360-degree overview of the clinical research landscape in order to plan successful and on-time clinical trials. 

TrialHub does this by aggregating thousands of data sources in real-time and combining them with local experts’ insights. 

The data provided in this article is gathered in November 2020 and is based on 17 clinical trial registries ( etc.) and analytics about thousands of clinical trials. 

If you want to get an up-to-date and/or customized feasibility for COPD or need an assessment about a different indication or TA, please contact us at

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