State-of-the-Art in Chronic Obstructive Pulmonary Disease (COPD)

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 5924

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Guest Editor
Division of Pulmonary Medicine, Far Eastern Memorial Hospital, New Taipei City 22000, Taiwan
Interests: asthma; biological agents; inhaler agents
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Dear colleagues,

Chronic obstructive pulmonary disease (COPD) is a respiratory disease with significant contributions to morbidity and mortality worldwide and is a known risk factor of lung cancer. Despite the enormous and increasing social–economic burden associated with COPD, this illness is preventable and treatable. The complex and heterogeneous nature of COPD has prompted us to design a novel COPD therapeutic policy that addresses lung function severity, symptoms, serum biomarkers, phenotypes, and comorbidities. The clinical phenotypes should comprise a survey of frequent exacerbators, chronic bronchitis, ACOS, and bronchiectasis–COPD overlay syndrome. The treatment of patients with COPD in a more personalized way must address diverse aspects not only related to the disease, but also to its comorbidities, and current schemes do not offer such personalized medical treatment. Comorbidity evaluation and management were all mentioned in each clinical practice guideline (CPG), the comorbidities including systemic inflammation, osteoporosis, musculoskeletal defect, cardiovascular disorders, gastrointestinal dysfunction, depression, metabolic disorders, and obstructive sleep apnea. Additionally, the variability of the clinical presentation interacts with comorbidities to form a complex clinical scenario for clinicians. Different comorbidities have different evaluation and management policies. Consequently, the CPG or consensus should be reached over a practical approach for combining comorbidities and disease presentation markers in the therapeutic algorithm, in order to improve the quality of clinical care.

Dr. Shih-Lung Cheng
Guest Editor

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Keywords

  • COPD
  • individualized approach
  • precision therapy

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Published Papers (2 papers)

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2 pages, 188 KiB  
Comment
Comment on Liu et al. Application of High-Flow Nasal Cannula in COVID-19: A Narrative Review. Life 2022, 12, 1419
by Claudia Crimi and Andrea Cortegiani
Life 2022, 12(10), 1625; https://doi.org/10.3390/life12101625 - 18 Oct 2022
Cited by 1 | Viewed by 950
Abstract
We read the article “Application of High-Flow Nasal Cannula in COVID-19: A Narrative Review” by Liu and colleagues [...] Full article
(This article belongs to the Special Issue State-of-the-Art in Chronic Obstructive Pulmonary Disease (COPD))
16 pages, 14004 KiB  
Systematic Review
The Impact of 52-Week Single Inhaler Device Triple Therapy versus Dual Therapy on the Mortality of COPD Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Chih-Cheng Lai, Chao-Hsien Chen, Kuang-Hung Chen, Cheng-Yi Wang, Tsan-Ming Huang, Ya-Hui Wang and Hao-Chien Wang
Life 2022, 12(2), 173; https://doi.org/10.3390/life12020173 - 25 Jan 2022
Cited by 7 | Viewed by 4202
Abstract
There are more single inhaler device triple therapy available for COPD patients now. However, the effect of long-term triple therapy fixed dose combination (FDC) on mortality remains unclear. This study aimed to evaluate the impact of one-year single inhaler device triple therapy, including [...] Read more.
There are more single inhaler device triple therapy available for COPD patients now. However, the effect of long-term triple therapy fixed dose combination (FDC) on mortality remains unclear. This study aimed to evaluate the impact of one-year single inhaler device triple therapy, including long-acting β2-agonists (LABAs), long-acting muscarinic receptor antagonists (LAMAs), and inhaled corticosteroids (ICSs), with dual therapies, comprised of either LABA/LAMA or ICS/LABA, on the mortality of patients with COPD. We searched the PubMed, Cochrane library, Web of Science, Embase databases, and clinical trial registry of clinicaltrials.gov and WHO ICTRP. Randomized controlled trials (RCTs) compared single inhaler device triple and dual therapies for 52 weeks were selected for the meta-analysis. The primary endpoint was all-cause mortality. A total of 6 RCTs were selected for the meta-analysis, including 10,274 patients who received single inhaler device triple therapy (ICS/LABA/LAMA FDC) and 12,395 patients who received ICS/LABA or LABA/LAMA dual therapy. Risk of death was significantly lower in the ICS/LABA/LAMA FDC group compared to the LABA/LAMA group (RR = 0.69, 95% CI = 0.53–0.90, p = 0.007). There was no significant difference in mortality between the ICS/LABA/LAMA FDC and ICS/LABA therapy groups (RR = 0.94, 95% CI = 0.72–1.24, p = 0.66). In addition, patients receiving ICS/LABA/LAMA FDC therapy had less moderate or severe exacerbations compared with the dual therapy groups (RR = 0.76, 95% CI = 0.73–0.80, p < 0.001 for LABA/LAMA; RR = 0.84, 95% CI = 0.78–0.90, p < 0.001 for ICS/LABA). By contrast, the risk of pneumonia in the ICS/LABA/LAMA FDC group was higher than in the LABA/LAMA group (RR = 1.43, 95% CI = 1.21–1.68, p < 0.001). In conclusion, ICS/LABA/LAMA FDC therapy could help improve the clinical outcomes of patients with COPD. However, triple therapy could increase the risk of pneumonia in comparison with LABA/LAMA dual therapy. Full article
(This article belongs to the Special Issue State-of-the-Art in Chronic Obstructive Pulmonary Disease (COPD))
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