title: Lung function decline in COPD.
abstract: The landmark study of Fletcher and Peto on the natural history of tobacco smoke-related chronic airflow obstruction suggested that decline in the forced expiratory volume in the first second (FEV(1)) in chronic obstructive pulmonary disease (COPD) is slow at the beginning, becoming faster with more advanced disease. The present authors reviewed spirometric data of COPD patients included in the placebo arms of recent clinical trials to assess the lung function decline of each stage, defined according to the severity of airflow obstruction as proposed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. In large COPD populations the mean rate of FEV(1) decline in GOLD stages II and III is between 47 and 79 mL/year and 56 and 59 mL/year, respectively, and lower than 35 mL/year in GOLD stage IV. Few data on FEV(1) decline are available for GOLD stage I. Hence, the loss of lung function, assessed as expiratory airflow reduction, seems more accelerated and therefore more relevant in the initial phases of COPD. To have an impact on the natural history of COPD, it is logical to look at the effects of treatment in the earlier stages.
authors.affiliation: Unit of Respiratory Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy. tantucci@med.unibs.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Tantucci
authors.forename: Denise
authors.initials: D
authors.lastname: Modina
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D019317:Evidence-Based Medicine; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D012720:Severity of Illness Index; D013147:Spirometry; D013997:Time Factors