Chronic Obstructive Pulmonary Disease in Singapore: Current Perspectives on Prevalence, Disease Burden, and Treatment

Chronic obstructive pulmonary disease (COPD) represents a significant global health challenge, affecting millions worldwide, with an estimated prevalence of 5.9% specifically for Singapore, and a projected increase driven by population aging. Despite comprehensive healthcare infrastructure, COPD remains underdiagnosed and undertreated in Singapore. Real-world evidence indicates that most patients present with moderate-to-severe disease and exhibit high rates of comorbidities, including cardiovascular disorders, diabetes, and bronchiectasis, which complicate COPD management and increase healthcare utilization. Smoking remains the predominant risk factor, although non-smoking phenotypes linked to prior tuberculosis, biomass exposure, and environmental allergens are increasingly recognized. COPD imposes a significant economic burden, primarily driven by hospitalizations, and disproportionately affects certain ethnic groups, underscoring the need for culturally tailored interventions. Current treatment strategies for moderate-to-severe COPD emphasize smoking cessation, pulmonary rehabilitation, and inhaled bronchodilator therapy; however, substantial gaps persist, with frequent exacerbations despite triple therapy (long-acting β 2-agonists and long-acting muscarinic antagonists along with inhaled corticosteroids) and inappropriate oral corticosteroid use contributing to adverse outcomes. Recent advances in biologic therapies targeting type 2 inflammation, notably dupilumab, approved in Singapore in 2025 offer promising options for patients with uncontrolled COPD characterized by elevated blood eosinophils. Emerging biomarkers, such as fractional exhaled nitric oxide, may further refine patient selection for precision therapy. This review focuses on the current evidence on COPD epidemiology, clinical characteristics, risk factors, treatment patterns, and evolving therapeutic approaches in Singapore, highlighting opportunities to optimize patient care through early diagnosis and adoption of novel biologics to improve outcomes in this heterogeneous population.