Strategies to decrease exacerbations of chronic obstructive pulmonary disease: can they impact disease progression?

Preventing disease progression is a key element of chronic obstructive pulmonary disease (COPD) management. COPD exacerbations are adverse events that can result in a decline of lung function that can persevere. Therefore, reducing exacerbation frequency has the potential to affect disease progression and improve health status of COPD patients. This narrative review explores monitoring for disease progression in COPD and its potential association with COPD exacerbations.

Pharmacotherapy can slow down disease progression, but the effect is mediated only in part by reducing exacerbations. While disease progression is continuous, patients with established airflow obstruction in early stages appear more vulnerable to faster declines in lung function. Longitudinal monitoring of lung function and structure is necessary to identify patients with disease progression.

Pharmacotherapy is an effective option for preventing disease progression. A holistic approach including longitudinal pulmonary function testing, clinical symptoms and imaging may be necessary to detect disease progression for early intervention.