Up to 60% of patients with severe COPD are misdiagnosed

Experts in addressing Chronic Obstructive Disease (COPD) they affirm that the future of the disease must be directed towards precision medicine. To do this, they advocate identifying new biomarkers and tools that allow predicting the trajectory of the disease to design personalized monitoring and treatment plans.

This is the main conclusion of the latest edition of the Annual Review of Congresses (ARC) en EPOC, organized by Farma Field and developed by Luzán 5 Health Consulting, which was attended by a total of 205 healthcare professionals (137 online and 68 in person) to review the most important developments presented at the international and national congresses held this year, which has allowed them to «know where the diagnosis and treatment of COPD in the coming years ”, as explained Adolfo Baloira, head of the Pneumology Service of the Pontevedra Hospital Complex and coordinator of the meeting.

Advances in the management of COPD have improved the quality of life and survival of those affected, but it is still the fourth leading cause of death in developed countries and there is concern that the incidence is on the rise. The main problem clinicians face in changing this situation is that up to 60% of critically ill patients are poorly controlled. According to experts, the key to improving the prognosis of patients is through personalized or precision medicine.

For this reason, during the meeting, studies related to the potential use of various biomarkers were reviewed, such as low eosinophil count in peripheral blood, which has been associated with a poor response to inhaled corticosteroids, or the use of imaging techniques such as computerized tomography (CT), which could be used to detect COPD early.

This early diagnosis is also vital for the management of the disease. In this sense, the Dr. Borja García-Cosío, from the Son Espases University Hospital in Palma de Mallorca, has spoken to the attendees about the novel concept of «pre-COPD», which «could tell us where to look and how, helping to detect early», since it considers the symptoms, structural abnormalities or functional alterations that predispose to people to suffer from this respiratory disease.

Regarding treatment, Dr. Baloira has underlined the importance of recent studies that indicate that “triple therapy represents an improvement in general in patients with previous exacerbating COPD”, both in terms of symptom control and in reduction of mortality.

The problem is that it is estimated that more than 50% of those affected are non-compliant. On this point, the Dr. Myriam Calle, pulmonologist at the San Carlos Clinical Hospital in Madrid, has stressed that, in addition, “in many cases the lack of adherence occurs involuntarily.” For this reason, he has insisted on the need to carry out “much more personalized approaches and verify compliance with treatment and the appropriate inhalation technique”, since “not all devices are the same.”

Likewise, during this ARC in COPD a review of the novelties of the GesEPOC guide 2021 and the usefulness and use of spirometry in Spain has been debated. The Closing Conference was given by Dr. Arturo Huerta (Sagrada Familia Clinic, BCN) who reviewed, with great public interest, the role of new technologies and techniques such as machine learning, in improving disease management.

Spanish Covid vaccine and impact on COPD

The Inaugural Conference of this edition of the ARC on COPD has been dedicated to talking about vaccines against COVID-19, in a keynote talk led by the Dr. Luis Enjuanes, from the National Center for Biotechnology of the CSIC, who has advanced that at the beginning of 2022 they will be able to begin the trials in primates with the Spanish vaccine and that, “if everything were ideal, it could be well advanced by the end of next year.”

The main advantage of this vaccine is that it “confers sterilizing immunity”, whereas the current ones do not prevent infection or transmission of the virus. However, the expert has stressed the importance of using the vaccines that are currently on the market since, although “this is a designed and worked vaccine, it arrives late, if it arrives.”

With regard to the impact of the pandemic on the care of patients with COPD, experts have warned that “the monitoring of respiratory patients is in a very poor situation because measurement and evolution tools such as spirometry have been lost.”

For this reason, they request that the summons be expedited, the necessary tests be retaken and awareness campaigns be carried out so that both society and health professionals themselves become aware of the impact that COPD has in our country.

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