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People with COPD (chronic obstructive pulmonary disease) never know when to expect a flareup that could lead to difficulty breathing, hospitalization or worse – according to World Health Organization statistics, COPD is the third leading cause of death worldwide

A flareup can be brewing for weeks undetected. 

Tel Aviv-based RespirAI has developed an artificial intelligence (AI) algorithm that utilizes the sensor data from smartwatches or other wearable devices used to monitor chronic patients. 

The technology compares oxygen saturation levels (Sp02) and EKG results with the wearer’s physical movement to predict when a deterioration is imminent, alerting the patient and physician so that preventative action can be taken.

“We wanted to address an unmet need,” Nimrod Bin-Nun, RespirAI’s CEO, tells ISRAEL21c. “There were tools to monitor cardiac issues and diabetes at home. But for pulmonary issues like COPD, we couldn’t find anything.”

“Roughly 10% of COPD patients will die during a hospital stay. The two-year mortality rate following a hospitalization is a sobering 50%.”

This is significant because COPD is estimated to impact approximately 300 million people worldwide; one recent study predicts that global COPD prevalence could approach 600 million cases by 2050.

Bin-Nun explains that the company wished to bypass traditional approaches such as detecting biomarkers in the blood or having the patient breathe into a spirometer in a doctor’s office or undergo an MRI or CT scan. 

RespirAI is in the midst of clinical trials in Israel and aims to launch its product by early 2026.

Smoker’s disease

Characterized by inflammation and airway obstruction, COPD is not genetic; it is commonly known as emphysema or “smoker’s disease” because it affects nearly 20% of current and former smokers, although you can get COPD even if you’ve never puffed a cigarette. 

COPD patients typically experience difficulties in breathing, persistent coughing and fatigue. Flareups can occur several times a year, resulting in about 700,000 hospitalizations annually in the US. 

COPD flareups account for roughly 4% of total hospital stays – the fourth leading cause of hospitalization. The direct cost to hospitals is over $20 billion a year.

Even worse, roughly 10% of COPD patients will die during a hospital stay. The two-year mortality rate following a hospitalization is a sobering 50%.

There is no test that can provide an accurate assessment of disease status or predict effectively when it may get worse.

To remedy this situation, Bin-Nun founded RespirAI in 2020 with Assaf Gur, the company’s VP of R&D. 

Both men have medical technology backgrounds: Gur held senior managerial positions in several medical device companies while Bin-Nun has worked in business development at global pharmaceutical and medical device companies, including Teva and BioLight Life Sciences. 

The RespirAI team, from left: Shai Blechner, Rachel Mayer, Assaf Gur, Nimrod Bin-Nun, Dror Hibsh, Vladimir Yevsukov, Nadav Holzer. Photo courtesy of RespirAI

Always working in the background

The key to RespirAI’s AI is synchronization — checking if breathing and movement are in sync, comparing a patient’s current symptoms to his or her baseline. 

“When combined with AI, this enables early detection of COPD flareups and deterioration,” Bin-Nun says.

RespirAI makes use of the sensors already built inside almost all wearable devices. Its algorithms monitor COPD status in the background, so all the patient has to do is wear the device.

Most of the companies manufacturing wearables – such as Apple, Garmin and Samsung – “got regulatory approval for these amazing sensors,” Bin-Nun says. 

“Now, they have to figure out what to do with them. They’re not healthcare companies. So they’re looking for tech like ours, to provide the software to translate the hardware output into more actionable results.”

COPD patients tend to schedule meetings with their pulmonologist every few months, but, says Bin-Nun, “It’s usually at the wrong time, when the patient doesn’t need to see his or her doctor, or when it’s too late, after the patient has been released from the hospital following a flareup.” 

If RespirAI can detect an increase in COPD symptoms early, medications such as steroids can nip the problem in the bronchial bud.

Nebraska to Israel

In a reverse trend from how startups usually are typically formed in Israel, with R&D in the Holy Land and marketing overseas, RespirAI’s technology was not invented in Israel but at the University of Nebraska at Omaha. 

Bin-Nun says he and Gur were looking for a solution to address chronic respiratory conditions like COPD when they learned about the Nebraska algorithm. RespirAI subsequently received an exclusive license from the university. They have five employees.

All R&D and trials have been conducted in Israel. Some of those trials were scheduled to happen in the southwest, where the Hamas attacks on October 7 took place. This, and the reserve callup of some employees and physicians running the trials, has impacted the company’s timeline. 

The war with Hamas in Gaza has also put a damper on foreign investments, but the company has received support and funding from the Israel Innovation Authority (IIA) and has raised $2 million thus far. Its main backer is the venture capital firm eHealth Ventures, which also runs an incubator in which RespirAI participated. 

“Breathing should never be a luxury, and thanks to companies like RespirAI, it’s becoming a reality,” eHealth Ventures posted on LinkedIn. 

RespirAI is targeting as its first market outpatient pulmonology clinics.

The company has a signed agreement with the Mayo Clinic to jointly develop a platform to monitor COPD. A clinical trial at the Mayo Clinic focusing on COPD patients who have received a Zephyr Valve as part of their treatment is also in the works.

“This will lead to better patient outcomes, reduced healthcare costs, and improved quality of life for millions of individuals living with respiratory conditions,” Bin-Nun explains.

More information here. 

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