Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits

Alexander G Mathioudakis, Wim Janssens, Pradeesh Sivapalan, Aran Singanayagam, Mark T Dransfield, Jens-Ulrik Stæhr Jensen, Jørgen Vestbo, Alexander G Mathioudakis, Wim Janssens, Pradeesh Sivapalan, Aran Singanayagam, Mark T Dransfield, Jens-Ulrik Stæhr Jensen, Jørgen Vestbo

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant mortality, health and economic burden. Their diagnosis, assessment and management remain suboptimal and unchanged for decades. Recent clinical and translational studies revealed that the significant heterogeneity in mechanisms and outcomes of exacerbations could be resolved by grouping them etiologically. This is anticipated to lead to a better understanding of the biological processes that underlie each type of exacerbation and to allow the introduction of precision medicine interventions that could improve outcomes. This review summarises novel data on the diagnosis, phenotyping, targeted treatment and prevention of COPD exacerbations.

Keywords: COPD Exacerbations.

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form and declare no support by or financial relationship with any organisation that might have an interest in the submitted work in the previous 5 years. AGM reports grants from Boehringer Ingelheim, outside the submitted work. WJ reports grants from AstraZeneca, Boehringer Ingelheim and Chiesi Pharmaceuticals, outside the submitted work. PS reports personal fees from Boehringer Ingelheim and non-financial support from Novartis, outside the submitted work. AS reports personal fees from AstraZeneca, outside the submitted work. MD reports grants from the American Lung Association, NIH, Department of Veteran Affairs and the department of defence; personal fees and other support from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, PneumRx/BTG; personal fees from Mereo and Quark Pharmaceuticals; non-financial and other support from Pulmonx; other support from Boston Scientific, Novartis, Yungjin, Gala and Nuvaira; outside the submitted work. JV reports personal fees from Chiesi Pharmaceuticals, Boehringer-Ingelheim, Novartis, AstraZeneca and GlaxoSmithKline, outside the submitted work.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

Figures

Figure 1
Figure 1
Characterisation and aetiological treatment of acute exacerbations of chronic obstructive pulmonary disease.

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