Autor: |
Singh D; The University of Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland; dsingh@meu.org.uk., Han MK; University of Michigan, Ann Arbor, Michigan, United States., Bhatt SP; Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States., Miravitlles M; Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERS), Barcelona, Spain., Compton C; Global Medical Affairs, General Medicines, GSK, London, United Kingdom of Great Britain and Northern Ireland., Kolterer S; Specialty Medicines, GSK, London, United Kingdom of Great Britain and Northern Ireland., Mohan T; Global Medical Affairs, General Medicines, GSK, London, United Kingdom of Great Britain and Northern Ireland., Sreedharan SK; Global Medical Affairs, General Medicines, GSK, London, United Kingdom of Great Britain and Northern Ireland., Tombs L; Precise Approach Ltd, London, United Kingdom of Great Britain and Northern Ireland., Halpin DMG; University of Exeter Medical School, University of Exeter, Exeter, United Kingdom of Great Britain and Northern Ireland. |
Abstrakt: |
Chronic obstructive pulmonary disease (COPD) is a heterogenous lung condition characterized by progressive airflow obstruction. Despite advancements in diagnosis and treatment, the disease burden remains high; although clinical trials have shown improvements in outcomes such as exacerbations, quality of life, and lung function, improvement may not be attainable for many patients. For patients who do experience improvement, it is challenging to set management goals given the progressive nature of COPD. We therefore propose disease stability as an appropriate and attainable treatment goal. Other disease areas have developed definitions of no disease activity or remission, which provide relevant information for defining and achieving stability for patients with COPD. Disease stability builds on related concepts already defined in COPD such as clinical control and clinically important deterioration. Current components that could form part of a disease stability definition include exacerbations, health status (including quality of life and symptoms) and lung function. Considerations should be given to intervals over which stability is defined and assessed, appropriate thresholds, and defining a composite. Ensuring a holistic approach, objective measurements and harmonious, clear communication between patients and physicians can further support establishing disease stability. Here we propose a preliminary definition of disease stability, informed by existing research in COPD. Further research will be needed to validate the framework for use in clinical and research settings. Exploring disease stability as a goal, however, is an opportunity to develop and validate an attainable treatment target to advance the standard of care for patients with COPD. |