Tobias Welte (outgoing Editor in Chief) and
Robert Bals (incoming Editor in Chief)
After arteriosclerosis and stroke, COPD is one of the most common
diseases worldwide. The morbidity, mortality and healthcare costs
of COPD are high and will continue to rise due to the demographic
changes expected. Since the beginning of the millennium, COPD
has become one of the major areas of research. The improvement
in quality of life, and perhaps in life expectancy, achieved since then
is primarily due to the establishment of non-pharmacological
measures, such as standardised smoking-cessation programmes,
structured exercise therapy, and infection prevention with influenza
and pneumococcal vaccination.
Progress in pharmacological therapy, however, has been low. The
essential treatment components, such as β-mimetics,
anticholinergics or ICSs, have been available for more than
50 years, and have improved in terms of duration of action,
efficacy and mode of administration. However, more than 15
substances with new and different modes of action tested in
clinical trials have failed to demonstrate activity and have not been
approved for regular treatment. The dynamic development of new
therapies for asthma may explain why most of the COPD
substances failed. Better phenotyping of asthma patients made
targeted pathophysiology-oriented treatment possible. COPD is a
heterogeneous disease, and it is indisputable that there are different
phenotypes; however, with the exception of α1-ATD, these have
not been well characterised in the past. Better characterisation of
COPD patients using new biomarkers, advanced imaging
properties and the whole spectrum of omics technology may
stimulate the development of a new generation of drugs.
This issue of the ERS Monograph provides a comprehensive
overview of the debate in this context, with consideration of the
future direction of COPD research and clinical practice. We
would like to thank the Guest Editors Antonio Anzueto, Yvonne
Heijdra and John R. Hurst for their excellent work in bringing
together this interesting and wide-ranging selection of chapters.
We hope that both clinicians and scientists will find this book
Copyright ©ERS 2015. Print ISBN: 978-1-84984-063-7. Online ISBN: 978-1-84984-064-4. Print ISSN: 2312-508X. Online ISSN: 2312-5098.
Tobias Welte
Robert Bals
ERS Monogr 2015; 69: vii–viii. DOI: 10.1183/2312508X.10008315 vii
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