COPD: early diagnosis and treatment to slow disease progression. Issue 3 (31st October 2014)

• Record Type: Journal Article
• Authors: Welte, T.; Vogelmeier, C.; Papi, A.
• Is Part Of: International journal of clinical practice. Volume 69:Issue 3(2015)
• Page Start: 336
• Page End: 349
• Publication Date: 2014-10-31
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12522
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12522-abs-0001"> <title>Summary</title> <sec id="ijcp12522-sec-0001" sec-type="section"> <title>Aims</title> <p>Chronic obstructive pulmonary disease (COPD) is usually a progressive condition. Undiagnosed early‐stage disease, particularly in symptomatic patients, is likely to become more severe with time. Hence, prevention or reduction in disease progression is highly relevant. We evaluated the published data and discussed the potential impact of early intervention on the course of COPD.</p> </sec> <sec id="ijcp12522-sec-0002" sec-type="section"> <title>Methods</title> <p>We performed PubMed searches of studies in early or mild COPD, focusing on those relating to lung function decline.</p> </sec> <sec id="ijcp12522-sec-0003" sec-type="section"> <title>Results</title> <p>Smoking cessation reduced lung function decline at all stages of COPD, and the earlier the intervention, the greater the impact on lung function. Accumulating data from placebo‐controlled trials suggested that long‐acting bronchodilators can slow the decline in lung function, as well as reduce exacerbation and mortality rates and improve health‐related quality of life (HRQoL) in patients with mild‐to‐moderate COPD. Inhaled corticosteroids (ICS) do not impact lung function in early COPD, and further research is needed on the role of long‐acting β<sub>2</sub>‐agonist‐ICS combination therapy in these patients.</p> </sec> <sec id="ijcp12522-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Initiating treatment early in the course of COPD is likely to slow disease progression and improve HRQoL. Current data support maintenance treatment with a long‐acting bronchodilator in this patient group. However, many questions remain unanswered regarding the optimal treatment of mild COPD, and further research is required to develop evidence‐based recommendations in this field.</p> </sec> </abstract>