[Annual research progress in chronic obstructive pulmonary disease 2024]

Chronic obstructive pulmonary disease (COPD) is a major global public health problem and the burden of disease is estimated to continue to increase. Since 2023, significant progress has been achieved in the early identification, pathogenesis, biomarkers, and personalized treatment of COPD. Early-stage COPD, as defined by varying criteria, has been shown to have distinct epidemiological features that affect disease prognosis, emphasizing the importance of early monitoring and intervention. In terms of pathogenesis, terminal bronchial alveolar attachments have been identified as the initial sites of tissue destruction in centrilobular emphysema. Some circulating biomarkers have been shown to potentially play a role in multiple lung function trajectories leading to COPD. The discovery of the evolutionary pattern of the airway mucus microbiome provides a new direction for early intervention in COPD. Prognostic factors such as severity classification of COPD exacerbation from the Rome proposal, diffusion capacity, impulse oscillometry (IOS), and bronchodilator responsiveness are providing new insights for disease management. In terms of treatment, prompt initiation of triple inhalation therapy after an exacerbation has been shown to benefit patients who remain symptomatic despite dual therapy. The use of extra-fine particle formulations has been associated with a reduced risk of side effects from inhaled corticosteroids. New drugs, including ensifentrine and dupilumab, have been demonstrated both efficacy and safety. Future research will focus on disease heterogeneity, novel therapeutic targets and drugs to improve outcomes and reduce the burden of disease in COPD.