Early COPD diagnosis and treatment: A case report

Area of Science:

• Pulmonology
• Respiratory Medicine

Background:

• Chronic obstructive pulmonary disease (COPD) is a major global health issue, characterized by persistent respiratory symptoms and airflow limitation.
• Current diagnostic methods, including standard pulmonary function tests, often fail to detect early-stage obstructive airways disease.
• COPD is a leading cause of mortality worldwide, emphasizing the need for early diagnosis and effective treatment strategies.

Observation:

• A 72-year-old male ex-smoker presented with symptoms suggestive of early COPD.
• Initial pulmonary function tests were normal, with the exception of a reduced Forced Expiratory Flow between 25% and 75% of FVC (FEF_25-75).
• The patient showed no improvement with 6 months of monotherapy using a long-acting muscarinic antagonist (LAMA).

Findings:

• FEF_25-75 measurement proved crucial for identifying early-stage obstructive lung disease.
• A combination therapy of LAMA and a long-acting beta2 agonist (LABA) over 1 year resulted in significant clinical improvement and enhanced FEF_25-75.
• This case demonstrates the diagnostic utility of FEF_25-75 in detecting subtle airway obstruction.

Implications:

• The findings underscore the importance of FEF_25-75 in the early diagnosis and monitoring of COPD.
• Combination therapy with LAMA and LABA is effective for treating small airways obstruction in COPD patients.
• This approach may lead to earlier intervention and improved management of COPD, potentially reducing disease progression and exacerbations.