New Guideline Targets Treatment of Stable COPD

MONDAY Nov. 12, 2007 -- A new clinical guideline for diagnosing and treating the lung illness known as stable chronic obstructive pulmonary disease (COPD) has been released by the American College of Physicians (ACP).

COPD, typically caused by smoking, causes a gradual loss of lung function. It affects more than 5 percent of American adults and is the fourth leading cause of death and the 12th leading cause of illness in the United States. Symptoms range from chronic cough and wheezing to shortness of breath and significant limitation of activity.

According to the guideline:

  • Spirometry -- a test in which person blows into a machine -- should be performed to check for airflow obstruction in patients with respiratory symptoms, particularly shortness of breath. Spirometry shouldn't be used for patients with no symptoms.
  • Treatment of stable COPD should be limited to patients who have respiratory symptoms and forced expiratory volume in one second (FEV1) less than 60 percent predicted, as documented by spirometry.
  • Patients with COPD and FEV1 less than 60 percent predicted should be prescribed long-acting inhaled-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids.
  • Patients with COPD and insufficient levels of oxygen in the blood while resting should be prescribed oxygen therapy.

"The evidence does not support using spirometry as a diagnostic strategy for individuals not reporting respiratory symptoms," guideline co-author Dr. Steven Weinberger, the ACP's senior vice president of medical education and publishing, said in a prepared statement. "However, adding spirometry to clinical examinations for individuals with respiratory symptoms, especially shortness of breath, has demonstrated benefits," he added.

The guideline, based on a review of published studies, was published in the Nov. 6 issue of the journal Annals of Internal Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more about COPD.

Posted: November 2007


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