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COPD: Chronic Obstructive Pulmonary Disorder

IT’S NEVER TOO EARLY TO ACT ON COPD

PUT PREVENTION OF EXACERBATION AND EARLY DEATH AT THE CENTRE OF COPD MANAGEMENT

1. Halpin DMG, et al. Respir Med. 2017;128:85–91. 2. Rothnie K J, et al. Am J Respir Crit Care Med. 2018;198(4):464–471. 3. Anthonisen NR, et al. Ann Intern Med. 1987;106:196-204. 4. Singh D et al. International Journal of Chronic Obstructive Pulmonary Disease 2021:16 3009–30164. 5. Barnes N, et al. BMC Pulm Med. 2013;13:54. 6. Pavord ID, et al. Int J Chron Obstruct Pulmon Dis. 2016;11(special issue):21-30. 7. Global Initiative for Chronic Obstructive Lung Disease (GOLD). GLOBAL STRATEGY FOR THE DIAGNOSIS, MANAGEMENT, AND PREVENTION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (2023 REPORT). Available at: https://goldcopd.org/2023-gold-report-2/. Accessed at 22/10/2023. 8. Hoogendoorn M, et al. Int J Chron Obstruct Pulmon Dis. 2017;12:3183-3194. 9. Olortegui-Rodriguez, J.J. et al. (2022) ‘Prevalence and incidence of chronic obstructive pulmonary disease in Latin America and the Caribbean: A systematic review and meta-analysis’, BMC Pulmonary Medicine, 22(1). doi:10.1186/s12890-022-02067-y. 10. Suissa S, et al. Thorax. 2012;67:957-963. 11. Løkke, A. et al. (2022) ‘Disease trajectories and impact of one moderate exacerbation in gold B COPD patients’, International Journal of Chronic Obstructive Pulmonary Disease, Volume 17, pp. 569–578. doi:10.2147/copd.s344669. 12. Ho TW, et al. PLoS ONE. 2014;9(12):e114866. 13. Müllerová H, et al. BMJ Open. 2014;4(12):e006171. 14. Roche N, et al. Eur Resp J. 2017;50:OA1487. 15. Feng, L. et al. (2022) ‘Temporal trends in anxiety and depression prevalence and their association with adverse outcomes in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease in Beijing, China, from 2004 to 2020’, Frontiers in Psychiatry, 13. doi:10.3389/fpsyt.2022.996451. 16. Maurer, J. et al. (2008) ‘Anxiety and depression in COPD’, Chest, 134(4). doi:10.1378/chest.08-0342. 17. Giezeman, M. et al. (2023) ‘Comorbid heart disease in patients with COPD is associated with increased hospitalization and mortality – a 15-year follow-up’, International Journal of Chronic Obstructive Pulmonary Disease, Volume 18, pp. 11–21. doi:10.2147/copd.s378979. 18. Donaldson GC, et al.Chest. 2010;137(5):1091-1097. 19. Ferguson, G.T. et al. (2020) ‘unreported and overlooked: A post hoc analysis of COPD symptom-related attacks from the rise study’, International Journal of Chronic Obstructive Pulmonary Disease, Volume 15, pp. 3123–3134. doi:10.2147/copd.s277147. 20. Dalal A A, et al. Respir Res. 2012;13(1):41. 21. Coutinho AD, et al. Int J Chron Obstruct Pulmon Dis. 2016;11:1223–1231. 22. Bourbeau J, et al. Thorax. 2008;63:831-838. 23. Wedzicha JA, et al. Respir Care. 2003;48(12):1204-1215. 24. Bafadhel M, et al. Lancet Respir Med. 2018;6:117-126. 25. Dransfield MT, et al. Am J Respir Crit Care Med. 2017;195(3):324-330. 26. Westerik JAM, et al. Respir Res. 2017;18:31. 27. Rodriguez-Roisin, R. (2006) ‘COPD exacerbations {middle dot} 5: Management’, Thorax, 61(6), pp. 535–544. doi:10.1136/thx.2005.041863. 28. Kessler R, et al. CHEST.2006;130(1):133–142.

COPD: Chronic Obstructive Pulmonary Disorder
GOLD: Global Initiative for Chronic Obstructive Lung Disease

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It’s never too early to

Put prevention of exacerbation and early death at the centre of COPD management.

References:

1. Web log. American Lung Foundation (blog), February 13, 2023. https://www.lung.org/blog/heart-lung-relationship. 2. Watz H, et al. Respir Res 2018;19:251; 3. Suissa S, et al. Thorax 2012;67:957–963; 4. Donaldson GC, et al. Chest 2010;137:1091–1097; 5. Kunisaki KM, et al. Am J Respir Crit Care Med 2018;198:51–57; 6. Rothnie KJ, et al. Am J Respir Crit Care Med 2018;198:464–471; 7. Hurst JR, et al. Eur J Int Med 2020;73:1–6; 8. Pullen R, et al. Int J Chron Obstruct Pulmon Dis 2021;16:2301–2322; 16:3009-3016; 9. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for prevention, diagnosis and management of COPD. 2025. Available from: https://goldcopd.org/2025-gold-report/ (Accessed July 2025); 10. Müllerová H, et al. BMJ Open 2014;4:e006171; 11. Hughes R, et al. Respir Med 2022;200:106921; 12. Singh D et al. International Journal of Chronic Obstructive Pulmonary Disease 2021:16 3009–30164 13. Barnes N, et al. BMC Pulm Med. 2013;13:54. 14. Pavord ID, et al. Int J Chron Obstruct Pulmon Dis. 2016;11(special issue):21-30. 15. Graul EL, et al. Am J Respir Crit Care Med 2023; doi: 10.1164/rccm.202307-1122OC: Dec 21 [Epub ahead of print]. 16. Adeloye D et al. Lancet Resp Med. 2022;10:447-458. 17. Hurst JR, et al. N Engl J Med. 2010;363(12):1128-1138. 18. ClinicalTrials.gov. NCT00292552. Last date of access: March 2024. 19. Wallace AE, et al. J Manag Care Spec Pharm. 2019;25(2):205-217. 20. Koblizek V, et al. Eur Respir J. 2017;49(5):1601446. 21. Jones PW, et al. Am J Respir Crit Care Med. 2015;191:A2532. 22. Matsunaga K, et al. Respir Investig. 2015;53(2):82-85. 23. Hoogendoorn M, et al. Int J Chron Obstruct Pulmon Dis. 2017;12:3183-3194. 24. Tashkin DP, et al. N Engl J Med. 2008;359(15):1543-1554. 25. Roche N, et al. Eur Resp J. 2017;50:OA1487. 26. Kania A, et al. Int J Chron Obstruct Pulmon Dis. 2018;13:1613-1621. 27. Halpin DMG, et al. Respir Med. 2017;128:85–91. 28. Rothnie KJ et al. Ann Am Thorac Soc. 2018 Aug;15(8):935-946. doi: 10.1513/AnnalsATS.201710-815OC. PMID: 29723057; PMCID: PMC6322039. 29. Mannino DM, et al. Respir Med 2006;100:115–122. 30. Hughes R, et al. Respir Med 2022;200:106921 31. Bafadhel M, et al. Lancet Respir Med. 2018;6:117-126. 32. Lindberg A et al. Respir Med. 2015;109:88–95. 33. Dransfield MT, et al. Am J Respir Crit Care Med. 2017;195(3):324-330. 34. Westerik JAM, et al. Respir Res. 2017;18:31. 35. Kessler R, et al. CHEST. 2006;130(1):133–142. 36. Wedzicha JA, Mackay AJ, Singh R. COPD exacerbations: impact and prevention. Breathe. 2013; 9(6): 434-440 37. Ji Z, Jareño-Esteban JJ, de Miguel-Díez J. Role of Vaccines in COPD Patients. Open Respir Arch. 2022 Jun 15;4(3):100191 38. Simon, S, Joean, O, Welte, T, Rademacher, J The role of vaccination in COPD: influenza, SARS-CoV-2, pneumococcus, pertussis, RSV and varicella zoster virus. European Respiratory Review 2023 32(169) 39. Hogea S-P, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C. Risk factors of chronic obstructive pulmonary disease exacerbations. Clin Respir J. 2020; 14: 183–197. 40. Linden D, Guo-Parke H, Coyle PV, Fairley D, McAuley DF, Taggart CC, Kidney J. Respiratory viral infection: a potential “missing link” in the pathogenesis of COPD. Eur Respir Rev. 2019 Mar 14;28(151):180063 41. Papi A, Bellettato CM, Braccioni F, Romagnoli M, Casolari P, Caramori G, Fabbri LM, Johnston SL. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med. 2006 May 15;173(10):1114-21. doi: 10.1164/rccm.200506-859OC. Epub 2006 Feb 16. PMID: 16484677. 42. Bouquet J, Tabor DE, Silver JS, Nair V, Tovchigrechko A, Griffin MP, et al. Microbial burden and viral exacerbations in a longitudinal multicenter COPD cohort. Respir Res. 2020;21:1–13. doi: 10.1186/s12931-020-01340-0 43. Mathioudakis AG, Janssens W, Sivapalan P, Singanayagam A, Dransfield MT, Jensen J-US, et al. Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits. Thorax. 2020;75(6):520–527 44. Frickmann H, Jungblut S, Hirche TO, Groß U, Kuhns M, Zautner AE. The influence of virus infections on the course of COPD. Eur J Microbiol Immunol (Bp). 2012 Sep;2(3):176-85. doi: 10.1556/EuJMI.2.2012.3.2. Epub 2012 Sep 10 45. Dimopoulos G, Lerikou M, Tsiodras S, Chranioti A, Perros E, Anagnostopoulou U, Armaganidis A, Karakitsos P. Viral epidemiology of acute exacerbations of chronic obstructive pulmonary disease. Pulm Pharmacol Ther. 2012 Feb;25(1):12–18. doi: 10.1016/j.pupt.2011.08.004. 46. Bafadhel M, McKenna S, Terry S, et al. Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers. Am J Respir Crit Care Med. 2011;184(6):662-671. 47. Aaron SD, Donaldson GC, Whitmore GA, Hurst JR, Ramsay T, Wedzicha JA. Time course and pattern of COPD exacerbation onset. Thorax. 2012;67(3):238-243. 48. Wilkinson TM, Hurst JR, Perera WR, Wilks M, Donaldson GC, Wedzicha JA. Effect of interactions between lower airway bacterial and rhinoviral infection in exacerbations of COPD. Chest. 2006;129(2):317-324. 49. Falsey AR, Walsh EE, Esser MT, Shoemaker K, Yu L, Griffin MP. Respiratory syncytial virus-associated illness in adults with advanced chronic obstructive pulmonary disease and/or congestive heart failure. J Med Virol. 2019;91:65–71. 50. Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med. 2008;359:2355–65

*In some patients, lung function did not recover to pre-exacerbation levels by eight weeks after the start of the moderate exacerbation

†following a severe exacerbation, the rate of severe exacerbation increased and the time to subsequent exacerbations decreased

‡Singh, D., Han, M.K., Hawkins, N.M. et al. Implications of Cardiopulmonary Risk for the Management of COPD: A Narrative Review. Adv Ther (2024).
https://doi.org/10.1007/s12325-024-02855-4

**In a study conducted on patients with moderately severe COPD and rigorously adjudicated CVD events

***Cohort study that evaluated severe COPD exacerbations and their association with mortality in 73106 patients with their first severe COPD exacerbation requiring hospitalisation. Patients with data available between 1990 and 2005 were identified and followed until death or 31 March 2007

****Irreversibly reduce lung function

*****The relative risk of MI returned to near baseline, similar to any other post exacerbation time interval

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IT’S NEVER TOO EARLY TO ACT ON COPD

REFERENCES