Rate of Lung Function Decline as an Outcome in COPD

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The MD Magazine Peer Exchange “Expanding Treatment Options: The Latest Developments in COPD Therapy” features a panel of physician experts discussing key topics in COPD therapy, including risk factors, personalized treatment, preventive measures, new combination therapies, and more.

This Peer Exchange is moderated by Peter Salgo, MD, professor of medicine and anesthesiology at Columbia University and an associate director of surgical intensive care at the New York-Presbyterian Hospital in New York City.

The panelists are:

• Byron Thomashow, MD, professor of medicine at Columbia University Medical Center, medical director at the Jo-Ann LeBuhn Center for Chest Disease at New York-Presbyterian Hospital, and chairman of the board of the COPD Foundation
• Neil R. MacIntyre, MD, clinical chief of the Pulmonary/Critical Care Division, medical director of Respiratory Care Services, and professor of medicine at Duke University School of Medicine
• Barry J. Make, MD, director of Pulmonary and Respiratory Care for National Jewish Health and professor of medicine at the University of Colorado School of Medicine
• Nicola A. Hanania, MD, MS, associate professor of medicine and director of the Asthma and COPD Clinical Research Center at Baylor College of Medicine

Declining lung function is a major problem in COPD, and one of the only interventions that have been shown to slow down this decline is smoking cessation, said Hanania. Because a study of the decline in lung function would require a very long-term study with thousands of patients, this outcome is unfortunately not being tested.

Hanania also observed that the patients who have the fastest rate of decline are those with moderate COPD, not severe COPD. Similarly, patients with mild disease can also have frequent exacerbations, again pointing toward the importance of treating to the specific COPD phenotype.