Current Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease.

2.50
Hdl Handle:
http://hdl.handle.net/11287/619940
Title:
Current Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease.
Authors:
Singh, D.; Roche, N.; Halpin, David M; Agusti, A.; Wedzicha, J. A.; Martinez, F. J.
Abstract:
Clinical phenotyping is currently used to guide pharmacological treatment decisions in chronic obstructive pulmonary disease (COPD), a personalized approach to care. Precision medicine integrates biological (endotype) and clinical (phenotype) information for a more individualized approach to pharmacotherapy, to maximize the benefit versus risk ratio. Biomarkers can be used to identify endotypes. To evolve toward precision medicine in COPD, the most appropriate biomarkers and clinical characteristics that reliably predict treatment responses need to be identified. FEV1 is a marker of COPD severity and has historically been used to guide pharmacotherapy choices. However, we now understand that the trajectory of FEV1 change, as an indicator of disease activity, is more important than a single FEV1 measurement. There is a need to develop biomarkers of disease activity to enable a more targeted and individualized approach to pharmacotherapy. Recent clinical trials testing commonly used COPD treatments have provided new information that is likely to influence pharmacological treatment decisions both at initial presentation and at follow up. In this Perspective, we consider the impact of recent clinical trials on current COPD treatment recommendations. We also focus on the movement toward precision medicine and propose how this field needs to evolve in terms of using clinical characteristics and biomarkers to identify the most appropriate patients for a given pharmacological treatment.
Citation:
Current Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease. 2016, 194 (5):541-9 Am. J. Respir. Crit. Care Med.
Publisher:
American Thoracic Society
Journal:
American journal of respiratory and critical care medicine
Issue Date:
1-Sep-2016
URI:
http://hdl.handle.net/11287/619940
DOI:
10.1164/rccm.201606-1179PP
PubMed ID:
27585383
Additional Links:
http://www.atsjournals.org/doi/abs/10.1164/rccm.201606-1179PP?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Type:
Journal Article
Language:
en
ISSN:
1535-4970
Appears in Collections:
Respiratory Medicine; 2016 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorSingh, D.en
dc.contributor.authorRoche, N.en
dc.contributor.authorHalpin, David Men
dc.contributor.authorAgusti, A.en
dc.contributor.authorWedzicha, J. A.en
dc.contributor.authorMartinez, F. J.en
dc.date.accessioned2016-09-07T09:35:06Z-
dc.date.available2016-09-07T09:35:06Z-
dc.date.issued2016-09-01-
dc.identifier.citationCurrent Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease. 2016, 194 (5):541-9 Am. J. Respir. Crit. Care Med.en
dc.identifier.issn1535-4970-
dc.identifier.pmid27585383-
dc.identifier.doi10.1164/rccm.201606-1179PP-
dc.identifier.urihttp://hdl.handle.net/11287/619940-
dc.description.abstractClinical phenotyping is currently used to guide pharmacological treatment decisions in chronic obstructive pulmonary disease (COPD), a personalized approach to care. Precision medicine integrates biological (endotype) and clinical (phenotype) information for a more individualized approach to pharmacotherapy, to maximize the benefit versus risk ratio. Biomarkers can be used to identify endotypes. To evolve toward precision medicine in COPD, the most appropriate biomarkers and clinical characteristics that reliably predict treatment responses need to be identified. FEV1 is a marker of COPD severity and has historically been used to guide pharmacotherapy choices. However, we now understand that the trajectory of FEV1 change, as an indicator of disease activity, is more important than a single FEV1 measurement. There is a need to develop biomarkers of disease activity to enable a more targeted and individualized approach to pharmacotherapy. Recent clinical trials testing commonly used COPD treatments have provided new information that is likely to influence pharmacological treatment decisions both at initial presentation and at follow up. In this Perspective, we consider the impact of recent clinical trials on current COPD treatment recommendations. We also focus on the movement toward precision medicine and propose how this field needs to evolve in terms of using clinical characteristics and biomarkers to identify the most appropriate patients for a given pharmacological treatment.en
dc.language.isoenen
dc.publisherAmerican Thoracic Societyen
dc.relation.urlhttp://www.atsjournals.org/doi/abs/10.1164/rccm.201606-1179PP?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmeden
dc.rightsArchived with thanks to American journal of respiratory and critical care medicineen
dc.subjectWessex Classification Subject Headings::Respiratory medicineen
dc.titleCurrent Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease.en
dc.typeJournal Articleen
dc.identifier.journalAmerican journal of respiratory and critical care medicineen
dc.type.versionPublisheden

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