State-of-the-Art in Chronic Obstructive Pulmonary Disease (COPD)

Dear colleagues,

Chronic obstructive pulmonary disease (COPD) is a respiratory disease with significant contributions to morbidity and mortality worldwide and is a known risk factor of lung cancer. Despite the enormous and increasing social–economic burden associated with COPD, this illness is preventable and treatable. The complex and heterogeneous nature of COPD has prompted us to design a novel COPD therapeutic policy that addresses lung function severity, symptoms, serum biomarkers, phenotypes, and comorbidities. The clinical phenotypes should comprise a survey of frequent exacerbators, chronic bronchitis, ACOS, and bronchiectasis–COPD overlay syndrome. The treatment of patients with COPD in a more personalized way must address diverse aspects not only related to the disease, but also to its comorbidities, and current schemes do not offer such personalized medical treatment. Comorbidity evaluation and management were all mentioned in each clinical practice guideline (CPG), the comorbidities including systemic inflammation, osteoporosis, musculoskeletal defect, cardiovascular disorders, gastrointestinal dysfunction, depression, metabolic disorders, and obstructive sleep apnea. Additionally, the variability of the clinical presentation interacts with comorbidities to form a complex clinical scenario for clinicians. Different comorbidities have different evaluation and management policies. Consequently, the CPG or consensus should be reached over a practical approach for combining comorbidities and disease presentation markers in the therapeutic algorithm, in order to improve the quality of clinical care.

Dr. Shih-Lung Cheng
Guest Editor

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