title: The Challenges of Precision Medicine in COPD.
abstract: Pheno-/endotyping chronic obstructive pulmonary disease (COPD) is really important because it provides patients with precise and personalized medicine. The central concept of precision medicine is to take individual variability into account when making management decisions. Precision medicine should ensure that patients get the right treatment at the right dose at the right time, with minimum harmful consequences and maximum efficacy. Ideally, we should search for genetic and molecular biomarker-based profiles. Given the clinical complexity of COPD, it seems likely that a panel of several biomarkers will be required to characterize pathogenetic factors and their course over time. The need for biomarkers to guide the clinical care of individuals with COPD and to enhance the possibilities of success in drug development is clear and urgent, but biomarker development is tremendously challenging and expensive, and translation of research efforts to date has been largely ineffective. Furthermore, the development of personalized treatments will require a much more detailed understanding of the clinical and biological heterogeneity of COPD. Therefore, we are still far from being able to apply precision medicine in COPD and the treatable traits and FEV1-free approaches are attempts to precision medicine in COPD that must be considered still quite unsophisticated.
authors.affiliation: Chair of Respiratory Medicine, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy. mario.cazzola@uniroma2.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
authors.affiliation: Chair of Respiratory Medicine, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
authors.forename: Luigino
authors.initials: L
authors.lastname: Calzetta
authors.affiliation: Chair of Respiratory Medicine, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.|Division of Respiratory Medicine, Department of Internal Medicine, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Rogliani
authors.affiliation: Chair of Pharmacology, Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Matera
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001993:Bronchodilator Agents / Q000627:therapeutic use; D000066491:Clinical Decision-Making; D019468:Disease Management; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D000069444:Omalizumab / Q000627:therapeutic use; D010641:Phenotype; D057285:Precision Medicine / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D009626:Terminology as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D001993:Bronchodilator Agents; D000069444:Omalizumab; D007073:Immunoglobulin E