Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission

Stolz, Daiana; Mkorombindo, Takudzwa; Schumann, Desiree M.; Agustí, Àlvar; Ash, Samuel Y.; Bafadhel, Mona; Bai, Chunxue; Chalmers, James D.; Criner, Gerard J.; Dharmage, Shyamali; Franssen, Frits M.E.; Frey, Urs; Han, MeiLan K.; Hansel, Nadia N.; Hawkins, Nathaniel M.; Kalhan, Ravi; Königshoff, Mélanie; Ko, Fanny Wai San; Parekh, Trisha M; Powell, Pippa; Mölken, Maureen Rutten-van; Simpson, Jodie L.; Sin, Don D.; Song, Yuanlin; Suki, Bélâ; Troosters, Thierry; Washko, George R.; Welte, Tobias; Dransfield, Mark T.

doi:10.1016/s0140-6736(22)01273-9

Cited by 223 publications

(161 citation statements)

References 311 publications

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“…Because the causes, pathogenesis, clinical presentation, prognosis, and response to treatment in COPD are so heterogeneous, there is a major need to expand and refine the classification of COPD. In the Lancet Commission on COPD, Daiana Stolz and colleagues 6 provide an excellent comprehensive review of the epidemiology and pathophysiology of COPD, and discuss the challenges for optimal prevention, diagnosis, and treatment. Importantly, they propose a novel classification of COPD encompassing five types based on the predominant risk factors driving the disease (panel).…”

Section: Classification Of Copd: Fostering Prevention and Precision M...mentioning

confidence: 99%

Classification of COPD: fostering prevention and precision medicine in the Lancet Commission on COPD

Brusselle

Humbert

2022

The Lancet

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Section: Classification Of Copd: Fostering Prevention and Precision M...mentioning

confidence: 99%

Classification of COPD: fostering prevention and precision medicine in the Lancet Commission on COPD

Brusselle

Humbert

2022

The Lancet

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“…In high-income countries, cigarette smoking is the predominant risk factor for COPD, but not all smokers develop COPD and some cases occur in never-smokers. In this context, a 2022 international expert panel report emphasized renewed efforts in COPD prevention by identifying, besides smoking, other important risk factors for COPD [ 2 ]. One such factor is diet.…”

Section: Introductionmentioning

confidence: 99%

Healthful and Unhealthful Plant-Based Diets and Chronic Obstructive Pulmonary Disease in U.S. Adults: Prospective Study

et al. 2023

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Background: Despite the potential protective effect of a plant-based diet against chronic obstructive pulmonary disease (COPD), it remains unknown whether intake of different types of plant foods is beneficial for COPD. Our aims were to determine whether adherence to the healthful version of a plant-based diet (healthful Plant-based Diet Index (hPDI)) is associated with a lower COPD risk, whereas adherence to the unhealthful version (unhealthful Plant-based Diet Index (uPDI)) is associated with a higher COPD risk. Methods: 46,948 men from the Health Professionals Follow-up Study, 73,592 women from the Nurses’ Health Study, and 85,515 women from the Nurses’ Health Study II who completed biennial questionnaires from 1984–2018. We derived diet scores from repeated validated food frequency questionnaires. Among 5,661,994 person-years of follow-up, we documented 2605 validated COPD cases between 1984–2018. Results: After tight control for smoking and other potential confounders, COPD risk was 46% lower among participants with the highest hPDI score compared to those with the lowest score. Conversely, COPD risk was 39% higher among participants with the highest uPDI. Further adjustment for processed meat intake led to similar results. Conclusions: These findings provide further evidence for consuming a diet that emphasizes healthful plant foods to optimize lung health.

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“…1 Currently, pharmacotherapies for COPD include long-acting bronchodilators, inhaled corticosteroid, etc. 2 Although these drugs have shown great benefits to symptom relief and prognosis improvement, the mortality of COPD still ranked third worldwide. 3 High prevalence and mortality of COPD has brought huge health hazards and economic burden.…”

Section: Introductionmentioning

confidence: 99%

Could patients with chronic obstructive pulmonary disease benefit from renin angiotensin system inhibitors? A meta-analysis

Huang

Miao

et al. 2023

BMJ Open Resp Res

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BackgroundChronic obstructive pulmonary disease (COPD) is considered related to chronic systemic inflammation. Renin angiotensin system (RAS) inhibitor, exerting an anti-inflammatory action in many systems, has been demonstrated relevant to the pathogenesis of COPD. However, the association between RAS inhibitor use and prognosis of patients with COPD remains controversial. Therefore, we conducted a meta-analysis and systematic review to summarise current evidence.Material and methodsDatabases, including Medline, Embase, Web of Science and Cochran Library, were searched for eligible studies by the end of 30 September 2022. Observational studies or randomised controlled trials (RCTs) that investigated the association of RAS inhibitor use with prognosis of COPD (mortality or risk of acute exacerbation) were selected. The Newcastle-Ottawa Scale was used for quality assessment of observational studies, while the Cochrane risk-of-bias tool was used to assess the quality of RCTs. Statistical analyses were performed using Stata V.15. We selected relative risk (RR) with 95% CI as the effect measure. Heterogeneity was assessed by I-squared (I2) statistics. The funnel plot was used for visual assessment of publication bias.ResultsA total of 20 studies with 5 51 649 subjects were included in the meta-analysis. The overall analysis indicated that RAS inhibitor use decreased the risk of death in patients with COPD (RR: 0.69, 95% CI: 0.61 to 0.78). Subgroup analyses were conducted according to comorbidities, race and type of RAS inhibitors, and the results kept consistent. However, in the pooled analysis of prospective studies, RAS inhibitor use did not significantly decrease the mortality (RR: 0.89, 95% CI: 0.78 to 1.02). Additionally, the risk of exacerbations of COPD did not decrease in patients who were prescribed RAS inhibitors (RR: 0.99, 95% CI: 0.80 to 1.23). The funnel plot indicated significant publication bias.ConclusionRAS inhibitor use seemed to be associated with a reduction of mortality in patients with COPD. However, the available evidence is weak due to potential biases from retrospective studies and the heterogeneity across included studies.

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Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission

Cited by 223 publications

References 311 publications

Classification of COPD: fostering prevention and precision medicine in the Lancet Commission on COPD

Classification of COPD: fostering prevention and precision medicine in the Lancet Commission on COPD

Healthful and Unhealthful Plant-Based Diets and Chronic Obstructive Pulmonary Disease in U.S. Adults: Prospective Study

Could patients with chronic obstructive pulmonary disease benefit from renin angiotensin system inhibitors? A meta-analysis

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