Abstract
We are certainly moving towards a more accurate understanding of what chronic obstructive pulmonary disease (COPD) actually is. The development of definitions of this disease also testifies to this.
Chronic bronchitis was first described in 1880. Since then, a number of definitions have been published that better or worse expressed the nature of the disease.
The latest definition is from 2004. According to this definition, COPD is a preventable and treatable disease characterized by bronchial obstruction, which is not fully reversible.
Bronchial obstruction is both a progressive and associated sabnormal response of the lungs to noxious particles or gases. The primary cause is cigarette smoking.
COPD mainly affects the lungs, but it has serious systemic consequences. Another problem is the ambiguity as to which parameter best expresses the patient's difficulties and is therefore actually the goal of COPD treatment.
The lack of a generally acceptable measurable parameter for patients with COPD (other than FEV1 - exhaled volume in the first second), which could be used as a criterion for evaluating new treatment and approving new drugs, is detrimental to research and clinical practice. Experts belonging to GOLD also realized this.
Therefore, they recommend using the COPD evaluation results and marker. The clinical outcome is a consequence of COPD experienced by patients (symptoms, weight loss, decreased performance, exacerbation, need for medical treatment, mortality).
A marker is a measurable parameter associated with one or more clinical consequences. The reduction of risk factors, especially smoking prevention, plays a key role in influencing the further development of the disease.
There is no doubt that the introduction of long-acting β 2-sympathomimetics (LABA) and the long-acting anticholenergic tiotropium has brought significant progress in the treatment of COPD patients. Therefore, long-acting bronchodilators have become the basis of treatment.