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      Lung function decline in COPD

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          Abstract

          The landmark study of Fletcher and Peto on the natural history of tobacco smoke-related chronic airflow obstruction suggested that decline in the forced expiratory volume in the first second (FEV 1) in chronic obstructive pulmonary disease (COPD) is slow at the beginning, becoming faster with more advanced disease. The present authors reviewed spirometric data of COPD patients included in the placebo arms of recent clinical trials to assess the lung function decline of each stage, defined according to the severity of airflow obstruction as proposed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. In large COPD populations the mean rate of FEV 1 decline in GOLD stages II and III is between 47 and 79 mL/year and 56 and 59 mL/year, respectively, and lower than 35 mL/year in GOLD stage IV. Few data on FEV 1 decline are available for GOLD stage I. Hence, the loss of lung function, assessed as expiratory airflow reduction, seems more accelerated and therefore more relevant in the initial phases of COPD. To have an impact on the natural history of COPD, it is logical to look at the effects of treatment in the earlier stages.

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          The Natural History of Chronic Bronchitis and Emphysema

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            Author and article information

            Journal
            Int J Chron Obstruct Pulmon Dis
            Int J Chron Obstruct Pulmon Dis
            International Journal of COPD
            International Journal of Chronic Obstructive Pulmonary Disease
            Dove Medical Press
            1176-9106
            1178-2005
            2012
            2012
            09 February 2012
            : 7
            : 95-99
            Affiliations
            Unit of Respiratory Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
            Author notes
            Correspondence: Claudio Tantucci, Clinica di Medicina Interna I, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25100 Brescia, Italy, Tel +39 030 39 80 69, Fax +39 030 39 80 69, Email tantucci@ 123456med.unibs.it
            Article
            copd-7-095
            10.2147/COPD.S27480
            3282601
            22371650
            © 2012 Tantucci and Modina, publisher and licensee Dove Medical Press Ltd.

            This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

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