Reducing the risk of death - a possible outcome in COPD patients.

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Mauro Maniscalco, Luigino Calzetta, Paola Rogliani, Mario Cazzola
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Abstract

Introduction: COPD is a leading cause of global mortality, particularly under-recognized and under-diagnosed. In 2020, it was the sixth leading cause of death in the US and has contributed to 4.72% of all-cause mortality (ACM) according to the Global Burden of Disease Study 2017. Factors influencing COPD-related mortality include smoking, aging populations, comorbidities, sarcopenia, physical capacity, and lack of effective treatments.

Areas covered: This review discusses various factors influencing COPD-related mortality and analyzes observational studies and pivotal RCTs evaluating the impact of different therapies on ACM.

Expert opinion: COPD significantly impacts ACM, necessitating effective management strategies. Smoking cessation is crucial in reducing mortality risk. Exacerbation management and comorbidity treatment are essential to improve patient outcomes. Various therapeutic interventions, such as smoking cessation, vaccination, long-term oxygen therapy, and lung volume reduction surgery, have shown benefits in reducing mortality. Pharmacotherapies might reduce the risk of mortality, although the current scientific evidences remain inconclusive. Advances in pharmacological interventions, tailored treatment plans, and physical activity programs are vital. More robust and long-term studies, focusing on real-world data and addressing biases in treatment allocation, are needed to conclusively determine the efficacy of different therapies in reducing ACM in COPD patients.

降低死亡风险--慢性阻塞性肺病患者的一种可能结果。
导言:慢性阻塞性肺病是导致全球死亡的主要原因,尤其是认识不足和诊断不足。根据《2017 年全球疾病负担研究》,2020 年慢性阻塞性肺病是美国第六大死因,占全因死亡率(ACM)的 4.72%。影响慢性阻塞性肺疾病相关死亡率的因素包括吸烟、人口老龄化、合并症、肌肉疏松症、体能以及缺乏有效的治疗方法:本综述讨论了影响慢性阻塞性肺病相关死亡率的各种因素,并分析了评估不同疗法对ACM影响的观察性研究和关键RCT:专家观点:慢性阻塞性肺病对急性心肌梗死有重大影响,因此必须采取有效的管理策略。戒烟对降低死亡风险至关重要。病情加重管理和合并症治疗对改善患者预后至关重要。各种治疗干预措施,如戒烟、疫苗接种、长期氧疗和肺容积缩小手术,都显示出降低死亡率的益处。药物治疗可降低死亡风险,但目前的科学证据仍不确定。药物干预、量身定制的治疗计划和体育锻炼计划的进步至关重要。要想最终确定不同疗法在减少慢性阻塞性肺疾病患者 ACM 方面的疗效,还需要开展更多稳健而长期的研究,重点关注真实世界的数据,并解决治疗分配中的偏差问题。
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来源期刊
Expert Review of Clinical Pharmacology
Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
7.30
自引率
2.30%
发文量
127
期刊介绍: Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.
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