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

Abstract 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 w...

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Main Authors: Miriam Barrecheguren, Cruz González, Marc Miravitlles
Format: Article
Language:English
Published: BMC 2018-09-01
Series:Respiratory Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12931-018-0882-0
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spelling doaj-fa3dfcf50ea5439aa709a4b3dbcf9fa52020-11-24T22:01:02ZengBMCRespiratory Research1465-993X2018-09-0119111110.1186/s12931-018-0882-0What have we learned from observational studies and clinical trials of mild to moderate COPD?Miriam Barrecheguren0Cruz González1Marc Miravitlles2Pneumology Department, Hospital General Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES)Pneumology Department, Hospital Clínic UniversitariPneumology Department, Hospital General Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES)Abstract 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.http://link.springer.com/article/10.1186/s12931-018-0882-0COPDDiagnosisEpidemiologyGuidelinesMild-moderate diseasePhysical activity
collection DOAJ
language English
format Article
sources DOAJ
author Miriam Barrecheguren
Cruz González
Marc Miravitlles
spellingShingle Miriam Barrecheguren
Cruz González
Marc Miravitlles
What have we learned from observational studies and clinical trials of mild to moderate COPD?
Respiratory Research
COPD
Diagnosis
Epidemiology
Guidelines
Mild-moderate disease
Physical activity
author_facet Miriam Barrecheguren
Cruz González
Marc Miravitlles
author_sort Miriam Barrecheguren
title What have we learned from observational studies and clinical trials of mild to moderate COPD?
title_short What have we learned from observational studies and clinical trials of mild to moderate COPD?
title_full What have we learned from observational studies and clinical trials of mild to moderate COPD?
title_fullStr What have we learned from observational studies and clinical trials of mild to moderate COPD?
title_full_unstemmed What have we learned from observational studies and clinical trials of mild to moderate COPD?
title_sort what have we learned from observational studies and clinical trials of mild to moderate copd?
publisher BMC
series Respiratory Research
issn 1465-993X
publishDate 2018-09-01
description Abstract 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.
topic COPD
Diagnosis
Epidemiology
Guidelines
Mild-moderate disease
Physical activity
url http://link.springer.com/article/10.1186/s12931-018-0882-0
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AT cruzgonzalez whathavewelearnedfromobservationalstudiesandclinicaltrialsofmildtomoderatecopd
AT marcmiravitlles whathavewelearnedfromobservationalstudiesandclinicaltrialsofmildtomoderatecopd
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