Journal Article

What have we learned from observational studies and clinical trials of mild to moderate COPD?

Barrecheguren, Miriam, Miravitlles, Marc, González, Cruz

2018

Overview

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. It is well established that patients with mild to moderate disease represent the majority of patients with COPD, and patients with mild COPD already have measurable physiological impairment with increased morbidity and a higher risk of mortality compared with healthy non-smoking individuals. However, this subpopulation is both underdiagnosed and undertreated. In addition, most clinical trials include cohorts of patients with worse lung function and quality of life, which are very different from the milder patients usually seen in primary care. Clinical trials have shown that mild-moderate COPD patients present an improvement in lung function after treatment with long-acting bronchodilators (LABD). Inhaled therapy has also shown benefits in terms of symptoms, health-related quality of life (HRQL) and exacerbation prevention in this population. Early intervention might have also a positive effect to prevent functional impairment. Nevertheless, there is scarce evidence from randomised clinical trials and real-life studies about the importance of pharmacological treatment in early stages of COPD to improve long-term outcomes. New concepts such as clinically important deterioration may help to investigate the impact of interventions on the natural history of the disease.

• Publisher: BioMed Central,BioMed Central Ltd,Nature Publishing Group,BMC
• Subject: Age / Analysis / Bronchodilator agents / Bronchodilator Agents - administration & dosage / Bronchodilators / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Clinical trials / Clinical Trials as Topic - methods / COPD / Diagnosis / Dosage and administration / Drug therapy / Epidemiology / Guidelines / Health care / Health risk assessment / Health services / Humans / Impairment / Lung diseases / Lungs / Medical research / Medicine / Medicine & Public Health / Mild-moderate disease / Morbidity / Mortality / Mortality risk / Natural history / Observational studies / Observational Studies as Topic - methods / Obstructive lung disease / Patient outcomes / Patients / Pharmacology / Physical activity / Physiology / Pneumology/Respiratory System / Prevention / Primary care / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - drug therapy / Pulmonary Disease, Chronic Obstructive - physiopathology / Quality of Life / Respiratory function / Review / Smoking / Studies / Systematic review