Biologic Therapies for Chronic Obstructive Pulmonary Disease: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
Despite limited breakthroughs in COPD pharmacotherapy, recent trials have shown promising results for biologics in COPD patients. However, robust evidence synthesis in this area is currently lacking.
Previous Infection as a Risk Factor of COPD Exacerbations Leading to Hospitalization
() and () are associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD); however, their role in the pathogenesis of COPD is unknown. We retrospectively analysed the clinical data of patients with AECOPD (modified British Medical Research Council scale score, Global Initiative for Chronic Obstructive Lung Disease [GOLD] classification, pre-admission antibiotic and inhalant usage, sputum culture and epidemic influenza virus antigen test) for association with admission frequency. Among 169 eligible patients, pathogens were and were not detected in 64 and 105, respectively. The GOLD classification grade was higher in the non-detection group with a prior antimicrobial administration rate of 21.9% than in the detection group. and , each identified in 24.6% of the total number of detected pathogens, were the most common infectious bacteria. The GOLD classification grade was higher in the re-hospitalisation group than in the one-time hospitalisation group ( < 0.01). Regarding type of pathogen, infection ( = 16) was more common in the re-hospitalisation group. History of infection and GOLD grade ≥ III were risk factors for re-hospitalisation, with odds ratios of 92.7 (95% confidence interval [CI]: 3.68-2340.0, < 0.01), 20.1 (CI: 1.48-274.0, < 0.05) and 9.83 (CI: 2.33-41.4, < 0.01), respectively. These bacterial infections and severe airway limitation were associated with increased AECOPD frequency. Routine microbial monitoring may be useful for AECOPD prevention, reducing medical burden and improving prognosis.
The Role of Autophagy and Cell Communication in COPD Progression: Insights from Bioinformatics and scRNA-seq
Chronic obstructive pulmonary disease (COPD) is characterized by restricted airflow that leads to significant respiratory difficulties. This progressive disease often results in diminished pulmonary function and the onset of additional respiratory conditions. Autophagy, a critical cellular homeostasis mechanism, plays a significant role in the exacerbation of COPD. In this study, we utilized various bioinformatics tools to identify autophagy-related genes activated by smoking in individuals with COPD. Furthermore, we explored the immune landscape of COPD through these genes, analyzing cell communication patterns using scRNA-seq data. This analysis focused on key pathways between epithelial cells and other cellular subpopulations with different autophagy scores, essential for understanding the initiation and progression of COPD.
Knowledge Domain and Emerging Trends in the Treatment of Patients with Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure: A Scientometric Review Based on CiteSpace Analysis
To analyze the status of research on treating chronic obstructive pulmonary disease (COPD) combined with respiratory failure internationally to reveal its development trends through visualization methods and to provide a reference and suggestions for future research directions.
2025 GOLD Report: What is New and What is Noteworthy for the Practicing Clinician
A Scoping Review of Factors Influencing Smoking Cessation in Patients with Chronic Obstructive Pulmonary Disease
To provide a scoping review of studies on factors affecting smoking cessation in patients with chronic obstructive pulmonary disease (COPD), so as to provide a basis for healthcare professionals to intervene early in the process of cessation of smoking in patients with COPD, and to formulate personalized interventions for smoking cessation. Arksey and O'Malley's scoping review methodology as a framework, searched databases including CNKI, Wanfang Data, VIP, China Biomedical Database, PubMed, Web of Science, Embase, ProQuest, CINAHL, and Cochrane Library to collect literature on factors influencing smoking cessation among COPD patients. The literature was screened, data extracted, and summarized accordingly. A total of 28 papers were included. The socio-demographic related factors affecting smoking cessation in patients with COPD were age, educational level, residence, marital status, occupational status, economic status, race, and sex; tobacco related factors included smoking index, smoking duration (years), cumulative smoking (packs/year), smoking intensity (packs/day), and tobacco addiction; disease related factors included mMRC score, GOLD level, severity of airflow restrictions, symptom, activity limitation due to lung problems, history of deterioration in outpatient care, receipt of COPD medication, receipt of lung CT, receipt of pulmonary function tests, receipt of surgery, and comorbid comorbidities; psychologically related factors included mental health status, quit smoking health beliefs, smoking cessation self-efficacy, motivation to quit smoking, stress, and adverse emotions; environmental/Interpersonal network related factors-included environmental impacts, social support, family support, tobacco control policies, and satisfaction with cessation care; and behavior related factors included alcohol consumption, coffee consumption, eating, physical activity, and have a hobby. Healthcare professionals should avoid critical education of COPD patients in the process of smoking cessation management, pay attention to the adverse effects of medication side effects on patients, emphasize the improvement of patients' health beliefs and self-efficacy in smoking cessation, and help patients to establish a correct cognition of smoking cessation.
Risk Factors for Adults with Chronic Obstructive Pulmonary Disease in the United States, Utilizing State-Based Surveillance
Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous condition. Exposure to tobacco smoke and air pollutants are key risk factors for COPD development; however, other risk factors include race/ethnicity, sex of adults, a history of asthma, occupational exposures, and chronic respiratory infections. Data for the current study were from the 2022 Behavioral Risk Factor Surveillance Survey. Chi-squares and multinomial logistic regression analyses, adjusted with the survey's sampling weight, were used to examine how critical health indicators impacted a COPD diagnosis. Participants ( = 311,175) were adults aged 45 years and older. Adjusted multinomial regression analyses showed adults who reported asthma, current and former smoking, poor physical health, depression, less physical activity, and fatigue were more likely to report COPD. Those with COPD were more likely to be male than female. Moreover, those with COPD reported higher rates of health insurance coverage, and yet had lower income and more financial difficulty affording a doctor for health services. In a follow up regression analysis, examining racial differences in COPD for participants, American Indian adults had a higher odds of reporting COPD than the "other" race groups. Because COPD remains a leading cause of death and disability in the U.S., and racial disparities persist in respiratory outcomes, continuing to identify risk factors for vulnerable groups could assist health program planners with development of successful health messaging.
Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
The prevalence of combinations of comorbidities and their associations with inpatient service utilization and readmission among patients with chronic obstructive pulmonary disease (COPD) have not been extensively examined. To address this gap in knowledge, an observational prospective study was conducted using retrospective data.
Changes in Hospital Admissions of Patients with COPD in Poland: A 14-Year Nationwide Analysis (2006-2019)
Poland is a country with a high burden of COPD and its risk factors. This population-wide and geospatial study on COPD in Poland, aimed to analyze changes in hospitalizations of patients with a diagnosis of COPD between 2006 and 2019 as well as to identify changes in the demographic characteristics of patients hospitalized with COPD. This is a retrospective analysis of hospital discharge records of patients with a diagnosis of COPD (ICD-10 code J44 and age 40 and over), hospitalized in Poland between 2006 and 2019. Data were analyzed separately for all patients hospitalized with COPD (primary and secondary diagnosis), for patients admitted due to COPD (primary diagnosis) and patients hospitalized with COPD as a comorbidity (secondary diagnosis). Between 2006 and 2019, a total of 1,663,420 hospital admissions of patients with COPD were reported. Between 2006 and 2019, the annual number of patients hospitalized due to COPD decreased by 53.8%, including 57.3% among men and 46.6% among women. The number of patients hospitalized with COPD as comorbidity increased by 35.8%. The lowest hospital admissions rate was in north-western Poland and the highest in north-eastern Poland. Among patients admitted due to COPD, the percentage of women increased from 32.6% to 37.7%. The percentage of patients admitted due to COPD and living in rural areas decreased from 51.2% in 2006 to 40.8%in 2019. This study provided data on changes in sociodemographic characteristics of hospitalizations of patients with a diagnosis of COPD, including overall reduction in COPD admissions but an increase in COPD burden among women.
Dendritic Cells Promote the Differentiation of ILCs into NCRILC3s in the Lungs of Mice Exposed to Cigarette Smoke
The involvement of Group 3 innate lymphoid cells (ILC3s) and dendritic cells (DCs) in chronic lung inflammation has been increasingly regarded as the key to understand the inflammatory mechanisms of smoke-related chronic obstructive pulmonary disease (COPD). However, the mechanism underlying the engagement of both remains unclear. Our study aimed to explore NCRILC3 differentiation in the lungs of mice exposed to cigarette smoke (CS) and to further investigate whether DCs activated by CS exposure contribute to the differentiation of ILCs into NCRILC3s. The study involved both and experiments. In the former, the frequencies of lung NCRILC3s and NKp46IL-17A ILCs and the expression of DCs, CD40, CD86, IL-23, and IL-1β quantified by flow cytometry were compared between CS-exposed mice and air-exposed mice. In the latter, NKp46IL-17A ILC frequencies quantified by flow cytometry were compared after two cocultures, one involving lung CD45LinCD127 ILCs sorted from air-exposed mice and DCs sifted by CD11c magnetic beads from CS-exposed mice and another including identical CD45LinCD127 ILCs and DCs from air-exposed mice. The results indicated significant increases in the frequencies of NCRILC3s and NKp46IL-17A ILCs; in the expression of DCs, CD40, CD86, IL-23, and IL-1β in CS-exposed mice; and in the frequency of NKp46IL-17A ILCs after the coculture with DCs from CS-exposed mice. In conclusion, CS exposure increases the frequency of lung ILCs and NCRILC3s. CS-induced DC activation enhances the differentiation of ILCs into NCRILC3s, which likely acts as a mediating step in the involvement of NCR-ILC3s in chronic lung inflammation.
Assessing the Causal Role of Walking Pace and Hand Grip Strength with Chronic Obstructive Pulmonary Disease Hospital: A Mendelian Randomization Study
Chronic obstructive pulmonary disease(COPD) hospitalization heightens risks for patients, including mortality, reduced quality of life, and financial strain. Walking pace (WP) and hand grip strength (HGS) are key indicators, their direct connection to COPD hospitalization is uncertain.
Physiological Assessment of ECCOR on the Work of Breathing in Exacerbations of COPD
The impact of extracorporeal carbon dioxide removal (ECCOR) on work of breathing and aeration in exacerbations of chronic obstructive pulmonary disease (AECOPD) is poorly understood.
Machine-Learning Model Identifies Patients With Alpha-1 Antitrypsin Deficiency Using Claims Records
Identifying patients with rare diseases like alpha-1 antitrypsin deficiency (AATD) is challenging. Machine-learning models may be trained to identify patients with rare diseases using large-scale, real-world databases, whereas electronic medical records have low numbers of confirmed cases and have limited use in training such models. We applied a machine-learning model to a large US claims database to identify undiagnosed symptomatic patients with AATD. Using deidentified data from the Komodo US claims database (April 26, 2016-January 31, 2023), a model was trained to identify symptomatic patients with high probability of AATD. Eighty claims records for high-probability candidates identified by the model were independently reviewed and validated by 2 clinical experts. The experts independently indicated that of the 80 high-probability candidate patients, 65 (81%) and 62 (78%) patients, respectively, should be tested for AATD. Feedback from this validation step informed model optimization. The optimized model was applied to claims data to identify symptomatic patients with probable AATD. Eleven and 14 "features" of the claims data were informative in distinguishing patients with AATD from patients with COPD without AATD and from unspecified chronic liver diseases. Moreover, patients with diagnosed AATD and COPD without AATD had unique cadences of similar medical events in their diagnostic journeys. Our work shows that a machine-learning model trained on a large US claims database can accurately identify symptomatic patients with AATD and provides useful insights into the diagnostic journey of patients with AATD.
Chest CT Airway and Vascular Measurements in Females with COPD or Long-COVID
Chest CT provides a way to quantify pulmonary airway and vascular tree measurements. In patients with COPD, CT airway measurement differences in females are concomitant with worse quality-of-life and other outcomes. CT total airway count (TAC), airway lumen area (LA), and wall thickness (WT) also differ in females with long-COVID. Our objective was to evaluate CT airway and pulmonary vascular and quality-of-life measurements in females with COPD as compared to ex-smokers and patients with long-COVID. Chest CT was acquired 3-months post-COVID-19 infection in females with long-COVID for comparison with the same inspiratory CT in female ex-smokers and COPD patients. TAC, LA, WT, and pulmonary vascular measurements were quantified. Linear regression models were adjusted for confounders including age, height, body-mass-index, lung volume, pack-years and asthma diagnosis. Twenty-one females (53 ± 14 years) with long-COVID, 17 female ex-smokers (69 ± 9 years) and 13 female COPD (67 ± 6 years) patients were evaluated. In the absence of differences in quality-of-life scores, females with long-COVID reported significantly different LA ( = 0.006) compared to ex-smokers but not COPD ( = 0.7); WT% was also different compared to COPD ( = 0.009) but not ex-smokers ( = 0.5). In addition, there was significantly greater pulmonary small vessel volume (BV) in long-COVID as compared to female ex-smokers ( = 0.045) and COPD ( = 0.003) patients and different large (BV) vessel volume as compared to COPD ( = 0.03). In females with long-COVID and highly abnormal quality-of-life scores, there was CT evidence of airway remodelling, similar to ex-smokers and patients with COPD, but there was no evidence of pulmonary vascular remodelling. www.clinicaltrials.gov NCT05014516 and NCT02279329.
Real World Study on the Reasons for eScalation or de-Escalation of Inhaled ThEraPies in COPD Patients: the STEPINCOPD Multicenter Observational Study
There is limited data on the reasons for escalation or de-escalation of COPD inhaled therapies in routine clinical practice, especially after the follow-up pharmacological treatment guidance on the 2019 GOLD report and the 2020 ERS guideline on ICS withdrawal.
Identification and Validation of Aging Related Genes Signature in Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is regarded as an accelerated aging disease. Aging-related genes in COPD are still poorly understood.
A Study on the Association between Cough Sensitivity and Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease
To investigate the relationship between cough sensitivity and acute exacerbation in stable chronic obstructive pulmonary disease (COPD) patients.
The Application of Self-Made Disseminating and Descending Breathing Exercises in Home Rehabilitation of Stable COPD
To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group ( = 35) and the control group ( = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group ( < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group ( < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group ( < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.
Beclometasone Dipropionate/Formoterol Fumarate is Similarly Effective to Budesonide/Formoterol Fumarate in Chinese Patients with COPD: The FORSYYN Double-Blind, Randomised Study
The fixed-dose combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) delivered pressurised metered-dose inhaler (pMDI) has demonstrated efficacy in chronic obstructive pulmonary disease (COPD), in studies predominantly conducted in Caucasian adults. The current study evaluated the efficacy and safety of BDP/FF pMDI in Chinese patients with COPD, as part of registration for COPD in China. This double-blind, double-dummy, randomised, parallel-group study was conducted in patients with COPD of Chinese ethnicity aged ≥40 years. After a 4-week open-label budesonide/formoterol fumarate (BUD/FF) run-in period, patients were randomised to BUD/FF or BDP/FF for 24 weeks. The primary objective was to demonstrate non-inferiority of BDP/FF to BUD/FF in terms of change from baseline in pre-dose morning forced expiratory volume in 1 sec (FEV) at Week 24 (i.e. the lower 95% CI limit of the difference was above the pre-defined non-inferiority margin of -0.07 L). Of 750 patients randomised (377 BDP/FF; 373 BUD/FF), 87.6% completed the study. The primary endpoint was met in both the per-protocol (adjusted mean difference -0.001 L [95% CI: -0.025, 0.022], non-inferiority < 0.001) and intention-to-treat populations (-0.001 L [-0.024, 0.022]; non-inferiority < 0.001). There were no statistically significant BDP/FF-BUD/FF differences for the secondary endpoints, and a similar proportion of patients had adverse events (BDP/FF, 51.7%; BUD/FF, 51.2%), with most mild/moderate in severity. In conclusion, BDP/FF pMDI was non-inferior to BUD/FF in terms of pre-dose morning FEV, supported by a range of secondary endpoints. Both treatments were similarly tolerated. The study supports the use of BDP/FF pMDI in Chinese patients with COPD.