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Redefining COPD

A proposal to expand the diagnostic criteria for COPD may help millions of patients get treatment earlier.

Chronic Obstructive Pulmonary Disease [COPD] is the fourth leading cause of death in the U.S., responsible for about 120,000 deaths every year.  Now, medical researchers at dozens of leading institutions around the nation have proposed updating the criteria for diagnosing early-stage disease which, if adopted, could increase the number of COPD patients by 2 to 5 million.

Approximately 12 million people in the United States have been diagnosed with COPD, and millions more are thought to have undiagnosed disease. The proposal expands the current diagnostic definition from a single measure – lung function – to include environmental exposure, breathing symptoms, and abnormal CT scans. 

“If we diagnose COPD based only on impaired lung function, then we miss many patients in the early stages of the disease,” said Dr. James Crapo, who is also a principal investigator of COPDGene®, a large nationwide study which correlated former smokers showing just one or two of the proposed criteria with their development of COPD over time. “While some physicians do empirically treat patients with symptoms, many patients are not getting therapy that can improve their symptoms, their quality of life, and might extend their lives.”

He added that people who do not meet the current diagnostic definition are now excluded from trials of experimental COPD therapies. “Our proposed diagnostic criteria could open clinical trials to these people, [and] stimulate important research of potential therapies to slow, stop or even prevent progression of the disease.”

COPD is a progressive, complex combination of airway inflammatory disease, chronic bronchitis and emphysema. Smoking is the most common cause of COPD, although about 15 percent of patients have never smoked.

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