Risk factors for FEV&lt;sub&gt;1&lt;/sub&gt; decline in mild COPD and high-risk populations

Chen, Shujing; Wang, Changhui; Li, Bing; Shi, Guochao; Li, Huiping; Zhang, Jing; Gu, Yutong; Zhou, Jian; Song, Yuanlin; Bai, Chunxue

doi:10.2147/copd.s118106

Cited by 20 publications

(24 citation statements)

References 42 publications

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“…Despite the overall negative outcome, the subgroup analyses revealed that those with less advanced lung disease appeared to obtain the benefit of reducing FEV 1 decline, supporting the relevance of early treatment . This idea is compelling, as later studies found that the FEV 1 decline may be more rapid during early stages . Therefore, if our objective is to alter the natural course of the disease by reducing the rate of FEV 1 decline, then the approach should comprise double bronchodilator treatment during the early stages of disease to slow progression, followed by either single or double bronchodilator therapy during more advanced stages according to the need for symptom control.…”

Section: Step Up From Single To Double Bronchodilationmentioning

confidence: 90%

Current controversies in the stepping up and stepping down of inhaled therapies for COPD at the patient level

et al. 2018

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The implementation of potential new step-up or step-down treatment recommendations in response to current guidelines is one of the main challenges currently faced in actual daily practice settings. In the present narrative review, we aim to discuss the relevance of these step-up and step-down proposals at the patient level in daily clinical practice. In particular, we aim to review the challenges associated with inhaled maintenance therapy for chronic obstructive pulmonary disease (COPD) in four clinical scenarios. First, we discuss the step up from single to double bronchodilation, including current controversies regarding the addition of a second bronchodilator versus initial treatment with two bronchodilators. Second, we discuss the step up from double bronchodilation to triple therapy while challenging current indications for inhaled steroid therapy and discussing triple therapy designs. Third, we discuss the step down from triple therapy to double bronchodilation while evaluating the effect of this downshift in risk categories on the patient according to the new classifications. Finally, we discuss the step down from double to single bronchodilation, with a special focus on safety. We believe this review will help to highlight the most relevant discussion points regarding the treatment of COPD in a manner that will stimulate and guide related clinical research.

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Section: Step Up From Single To Double Bronchodilationmentioning

confidence: 90%

Current controversies in the stepping up and stepping down of inhaled therapies for COPD at the patient level

et al. 2018

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“…The literature search identified several papers reporting data for disease progression in patients with mild COPD or smokers with abnormal lung function (Fig. 1) [29, 58–60]. There is evidence that patients with mild COPD have an accelerated FEV 1 decline compared with controls without COPD (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…There is evidence that patients with mild COPD have an accelerated FEV 1 decline compared with controls without COPD (Fig. 1) [29, 58]) and GOLD stages 2–4 [29], which is more prominent in patients with greater symptoms [29, 59]. In contrast, one study reported that male heavy smokers with FEV 1 /FVC > 0.7 had a more rapid rate of decline irrespective of whether they were above or below the lower limit of normal (LLN), compared with individuals with FEV 1 /FVC < 0.7 and < LLN, (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…1Studies reporting lung function decline in patients with mild COPD: Chen et al [58], Bridevaux et al [29], Brito-Mutunayagam et al [59], Mohamed Hoesein et al [60]. Inclusion criteria/study design: Chen et al [58], subjects aged 45–80 years with a history of smoking or exposure to second-hand smoke for > 10 years; high-risk control group had post-bronchodilator FEV 1 /FVC > 0.7 and FEV 1 < 95% predicted; mild COPD group had post-bronchodilator FEV 1 /FVC < 0.7 and FEV 1 > 80% predicted in the absence of bronchodilator or inhaled corticosteroid; Bridevaux et al [29], Swiss Study on Air Pollution and Lung Diseases in Adults cohort; considered symptomatic if chronic cough, phlegm or shortness of breath while walking reported at baseline (age range 18–60 years); Brito-Mutunayagam et al [59], subjects aged ≥18 years from the North West Adelaide Health Study cohort; resolution, persistence or progression of GOLD stage 0 determined at 3.5-year follow-up; Mohamed Hoesin et al [60], Dutch Belgian Lung Cancer Screening Trial; male heavy smokers (age range 47–80 years). Data shown are calculated from 3-year data described by Mohamed Hoesin et al [60].…”

Section: Introductionmentioning

confidence: 99%

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Weighing the evidence for pharmacological treatment interventions in mild COPD; a narrative perspective

Singh

D’Urzo

Donohue³

et al. 2019

Respir Res

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There is increasing focus on understanding the nature of chronic obstructive pulmonary disease (COPD) during the earlier stages. Mild COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 1 or the now-withdrawn GOLD stage 0) represents an early stage of COPD that may progress to more severe disease. This review summarises the disease burden of patients with mild COPD and discusses the evidence for treatment intervention in this subgroup. Overall, patients with mild COPD suffer a substantial disease burden that includes persistent or potentially debilitating symptoms, increased risk of exacerbations, increased healthcare utilisation, reduced exercise tolerance and physical activity, and a higher rate of lung function decline versus controls. However, the evidence for treatment efficacy in these patients is limited due to their frequent exclusion from clinical trials. Careful assessment of disease burden and the rate of disease progression in individual patients, rather than a reliance on spirometry data, may identify patients who could benefit from earlier treatment intervention. Electronic supplementary material The online version of this article (10.1186/s12931-019-1108-9) contains supplementary material, which is available to authorized users.

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“…The rate of decline in FEV1 from a study in Japan was 32 ml/year, and in the Lung Health Study, the declining was 45 ml/year. [3] However, declining lung function within 1 year among Indonesian patients with COPD remains to be clarified.…”

Section: Introductionmentioning

confidence: 99%

Rate of forced expiratory volume in one second and forced expiratory volume in one second/forced vital capacity decline among Indonesian patients with chronic obstructive pulmonary disease after a year of treatment

Ariawan

Yunus

Damayanti

et al. 2019

Int J App Basic Med Res

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Background: The rate of decline in lung function in chronic obstructive pulmonary disease (COPD) patients showed more profound decline than normal individuals. However, a 1-year lung function among Indonesian patients with COPD has not been elucidated. Aim: This study attempted to determine the rate of lung function decline in terms of obstruction variable among COPD patients after a 1-year of treatment. Materials and Methods: This retrospective cohort study measures the rate of decline in forced expiratory volume in 1 s (FEV1) and ratio of FEV1 to forced vital capacity (FEV1/FVC) in COPD patients at COPD Outpatient Clinic Persahabatan Hospital after 1-year of treatment. Results: There were 31 COPD patients with the prevalence of 1-year declined FEV1 and FEV1/FVC which were 83.9% and 51.6%, respectively. Among 1-year declined lung function group, there were significant ( P < 0.05) decline in FEV1 (121.53 ± 120 ml/year) and in FEV1/FVC (2.75 ± 0.47%). The rate of decline in FEV1 was more prevalent in Group D, while the rate of decline in FEV1/FVC was more prevalent in Group B. No significant associations were found between sex, age, respiratory complaints, smoking history, Brinkman index, type of cigarette, comorbid, educational level, diagnosed age, body mass index, symptoms-based COPD classification, and risk-based COPD classification, with the rate of decline in FEV1 and FEV1/FVC. Conclusions: Most patients had statistically significant rate of decline in FEV1 and FEV1/FVC within 1-year of COPD treatment. This study recognized an unfavorable prognosis in terms of irreversible deteriorating lung function of COPD patients despite therapeutic management.

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Risk factors for FEV<sub>1</sub> decline in mild COPD and high-risk populations

Cited by 20 publications

References 42 publications

Current controversies in the stepping up and stepping down of inhaled therapies for COPD at the patient level

Current controversies in the stepping up and stepping down of inhaled therapies for COPD at the patient level

Weighing the evidence for pharmacological treatment interventions in mild COPD; a narrative perspective

Rate of forced expiratory volume in one second and forced expiratory volume in one second/forced vital capacity decline among Indonesian patients with chronic obstructive pulmonary disease after a year of treatment

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