- A new review published in the New England Journal of Medicine (NEJM) updates clinicians on the clinical aspects of COPD by including a new algorithm for diagnosis and another for treatment, both based on the latest clinical research.
Why this matters
- COPD is the third leading cause of mortality globally, with a death toll predicted to reach 4.4 million by 2040.
- COPD should be seen as a clinical syndrome, rather than a single entity, which features chronic respiratory symptoms, structural pulmonary abnormalities, lung function impairment, or any combination.
- COPD is underdiagnosed, largely because it is viewed as a disease of the elderly.
- COPD should be diagnosed and treated as early as possible because earlier interventions can stabilize lung function decline.
- A new algorithm for diagnosis begins with family history and exposure to smoking or pollution, and includes monitoring with annual spirometry. Spirometry value of FEV1:FVC 1 ≤80% of predicted dictates whether to monitor with annual spirometry or to treat.
- Coexisting conditions and multimorbidity include ischemic heart disease, atrial fibrillation, heart failure, osteoporosis, lung cancer, gastroesophageal reflux, anxiety, and depression.
- A new treatment algorithm, which stratifies cases from mild to severe, includes blood eosinophil count 3 for adjustment of therapy.