Pre-COPD: Impact on prevention, detection, and treatment.

BACKGROUND AND

objectivesThe ability to identify individuals at risk for progression to chronic obstructive pulmonary disease (COPD) remains challenging. The concept of pre-COPD has been proposed as a framework to identify patients without current airflow obstruction at greatest risk for progression to COPD using a constellation of symptoms, physiologic changes, and structural changes on chest imaging. While multiple biomarkers are linked to the subsequent development of COPD in at-risk individuals, no single biomarker has emerged as the best predictor. The goal of this review is to define the concept of pre-COPD, summarize known biomarkers associated with later development of COPD, and address the impact of pre-COPD on patient care.

methodsNarrative Review

conclusionThe concept of pre-COPD can help meet current gaps in screening and care for patients at risk of progression to COPD. A framework definition of pre-COPD allows for identification of individuals at risk for progression to COPD and indicates increased morbidity and mortality. While the ideal biomarker for pre-COPD has not been identified, multimodal risk prediction scores and practical clinical definitions are emerging for use in clinical practice. Additional research is needed to better understand optimal clinical screening and management of patients with pre-COPD.