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ATS, ERS make recommendations for future COPD research

The American Thoracic Society and the European Respiratory Society have combined resources to issue a series of recommendations for the future of COPD research to attempt to determine the impact of COPD-related clinical practice guidelines on outcomes in patients with COPD.

“Although much progress has been made in the assessment and treatment of patients with COPD, a range of important questions remain,” Kevin C. Wilson, MD, senior director of Documents and Medical Affairs at the American Thoracic Society, said in a press release. “In our review of the evidence, we aimed to identify these knowledge gaps and highlight questions that will have the greatest impact on improving patient outcomes if addressed by future research.”

The recommendations, published jointly in the American Journal of Respiratory and Critical Care Medicine and the European Respiratory Journal, are a result of discussions by various clinicians, researchers, and patient advocates with expertise in COPD. 

Each society elected two co-chairs to invite a group of experts to take part in the recommendations. Participants were then divided into seven groups and topics were assigned to each group. A literature review of Medline for each topic was conducted and the results were sent to each group. The groups then reviewed the materials and deemed which studies were relevant to their topic. If a study was irrelevant, participants were able to supplement the materials with their own literature searches.

Each group acknowledged the current research and identified knowledge gaps and issued preliminary research recommendations.

The recommendations are in areas including, but not limited to, the outcomes of an intervention, the diagnosis of COPD, disease severity, comorbidities and smoking cessation.

Some of the highlighted recommendations include studies to:

• pinpoint which outcomes matter most to patients with COPD and, therefore, are specifically patient-centered outcomes in this population;
• ascertain whether there is a role for routine CT scanning among patients with newly diagnosed COPD;
• measure the precision of tools in detecting symptoms in patients at risk for COPD;
• determine the nature and ideal beneficial therapies of patients with concomitant chronic diseases;
• discern the influence of race, sex and socioeconomic status on the natural history and pathobiology of the disease;
• measure the potential benefits and harms of e-cigarettes;
• analyze whether smoking marijuana increases the incidence of COPD or not;
• assess whether the possible improvements in symptoms and quality of life after lung transplantation are good enough to warrant the donor resource; and
• evaluate the cost-effectiveness of integrative care in COPD.

The statement is not intended to provide clinical practice management recommendations on COPD, but rather research that will address gaps in the evidence in all areas of COPD. With the number of deaths associated with COPD expected to increase over the next decade, Guy Brusselle, MD, PhD, European Respiratory Society guidelines director, said in a press release that the document aims to improve the treatment of patients with COPD.

“The World Health Organization predicts that COPD will become the third leading cause of death worldwide by 2030. It is therefore a critical time for us to act with improving the management of people with the condition,” Brusselle said in the release. “This document provides us with a valuable point of reference for identifying the most effective types of research in the field of COPD. By identifying the right questions to ask, we aim to improve the diagnosis, assessment and treatment of people with COPD.” –by Ryan McDonald

Disclosure: Celli reports consulting for AstraZeneca. Please see the full study for a list of all other authors’ relevant financial disclosures.