Nick Hopkinson is a Reader in Respiratory Medicine at Imperial College as well as an Honorary Consultant Chest Physician at The Royal Brompton Hospital. He qualified in Medicine at Cambridge and The London Hospital Medical College and went on to train in Respiratory and General Internal Medicine at St George’s and St Thomas’ Hospitals. He is clinical lead for chronic obstructive pulmonary disease (COPD) at The Royal Brompton Hospital where he runs the Advanced COPD clinic where patients are assessed for novel treatments for their disease including endobronchial emphysema therapies. He has established a smoking cessation clinic within the trust and is responsible for developing pulmonary rehabilitation services.
Key areas of activity are the effective management and prevention of COPD focussing on novel lung volume reduction techniques, physiological assessment of skeletal muscle, physical activity and lung function, together with the promotion of high value treatment strategies and tobacco control.
Lung volume reduction in COPD
These approaches offer a chance to improve symptoms dramatically in what is otherwise a progressive disease. Starting with the first case series describing bronchoscopic lung volume reduction with endobronchial valves he showed it to be one of the very few interventions which improves survival in COPD that it reduces dynamic hyperinflation during exercise and improves chest wall synchrony and oxygen kinetics. He led the MRC funded BeLieVeR-HIFi study, the first double blind randomised controlled trial of endobronchial valves. He has also shown modern lung volume reduction surgery to have much lower morbidity and mortality than historical papers suggest. Current activity includes leading the CELEB trial, a multicentre NIHR funded study comparing valve placement and surgery directly. The UKLVR study is a BLF funded project to develop a national Lung Volume Reduction Register establishing a collaborative network.
Skeletal muscle dysfunction and limitation of physical activity in COPD
This has included demonstrating that skeletal muscle weakness occurs even in early COPD associated with reduced physical activity levels, investigating the effect of ACE-I and oral nitrate supplementation on skeletal muscle in COPD. He was a work package lead for the EU/IMI PROactive project developing a patient reported outcome for physical activity in COPD and has demonstrated the impact of pedometers to promote activity.
Smoking and tobacco control
Work to prevent uptake of smoking and help smokers to quit is fundamental to addressing the burden of COPD. Highlighting rates of child uptake of smoking contributed to the adoption of measures on standardised packaging for tobacco products and the ban on smoking in cars with children. He is a board member of Action on Smoking and Health (ASH) and serves on the Royal College of Physicians Tobacco Advisory Committee. International collaborations include the FRESHAIR project promoting lung health in low and middle income countries.
Developing strategies for high value care in treating and preventing COPD
COPD affects 1.3 million people in the UK. Ensuring that they receive good care and that high value interventions are prioritised is a major challenge. Key activities include developing the COPD discharge care bundle focusing on the delivery of high value interventions.
With the London Respiratory Network he developed the Breathing SPACE approach for reviewing the care of any chronically breathless patient.
He is a Fellow of The Royal College of Physicians an Invited Specialist of the International Primary Care Respiratory Group and is on the Council of The British Thoracic Society where he serves on the Science and Research Committee and has chaired the BTS COPD Specialist Advisory Group. He is online editor of the journal Thorax and blogs regularly for the British Medical Journal and elsewhere.
He serves on the NICE COPD guidelines committee.
As a medical adviser and spokesperson for the British Lung Foundation he appears regularly in print and broadcast media (including Newsnight, Today and Radio 4’s Inside Health).
et al., 2015, Acute Dietary Nitrate Supplementation and Exercise Performance in COPD: A Double-Blind, Placebo-Controlled, Randomised Controlled Pilot Study, PLOS One, Vol:10, ISSN:1932-6203
et al., 2015, Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial, The Lancet, Vol:386, ISSN:0140-6736, Pages:1066-1073
et al., 2016, Effective Bronchoscopic Lung Volume Reduction Accelerates Exercise Oxygen Uptake Kinetics in Emphysema, Chest, Vol:149, ISSN:0012-3692, Pages:435-446
et al., 2015, Lung Volume Reduction in Emphysema Improves Chest Wall Asynchrony, Chest, Vol:148, ISSN:0012-3692, Pages:185-195
et al., 2015, Pedometers to enhance physical activity in COPD: a randomised controlled trial, European Respiratory Journal, Vol:45, ISSN:1399-3003, Pages:347-354
et al., 2014, Skeletal muscle adiposity is associated with physical activity, exercise capacity and fibre shift in COPD, European Respiratory Journal, Vol:44, ISSN:1399-3003, Pages:1188-1198
et al., 2014, A Randomized Controlled Trial of Angiotensin-Converting Enzyme Inhibition for Skeletal Muscle Dysfunction in COPD, Chest, Vol:146, ISSN:1931-3543, Pages:932-940
et al., 2013, Child uptake of smoking by area across the UK, Thorax, Vol:69, ISSN:0040-6376, Pages:873-875
et al., 2012, Designing and implementing a COPD discharge care bundle, Thorax, Vol:67, ISSN:0040-6376, Pages:90-92
et al., 2013, Lung function indices for predicting mortality in COPD, European Respiratory Journal, Vol:42, ISSN:0903-1936, Pages:616-625
et al., 2011, The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study, Thorax, Vol:66, ISSN:0040-6376, Pages:425-429
Hopkinson NS, Shah PL, Polkey MI, 2011, Endobronchial Valves for Emphysema, New England Journal of Medicine, Vol:364, ISSN:0028-4793, Pages:381-382
et al., 2011, Can financial incentives for improvements in healthcare quality enhance identification of COPD in primary care?, Thorax, Vol:66, ISSN:0040-6376, Pages:630-630
et al., 2011, Atelectasis and survival after bronchoscopic lung volume reduction for COPD, European Respiratory Journal, Vol:37, ISSN:0903-1936, Pages:1346-1351
et al., 2008, Vitamin D receptor genotypes influence quadriceps strength in chronic obstructive pulmonary disease, American Journal of Clinical Nutrition, Vol:87, ISSN:0002-9165, Pages:385-390
et al., 2006, +9/+9 Homozygosity of the bradykinin receptor gene polymorphism is associated with reduced fat-free mass in chronic obstructive pulmonary disease, American Journal of Clinical Nutrition, Vol:83, ISSN:0002-9165, Pages:912-917
et al., 2004, Angiotensin converting enzyme genotype and strength in chronic obstructive pulmonary disease, American Journal of Respiratory and Critical Care Medicine, Vol:170, ISSN:1073-449X, Pages:395-399
et al., 2005, Effect of Bronchoscopic lung volume reduction on dynamic hyperinflation and exercise in emphysema, American Journal of Respiratory and Critical Care Medicine, Vol:171, ISSN:1073-449X, Pages:453-460