Introduction
Jadwiga A. Wedzicha1,2, James P. Allinson1,2 and Peter M.A. Calverley 3
1 Royal Brompton Hospital, London, UK. 2 National Heart and Lung Institute, Imperial College London, London, UK.
3 University of Liverpool, Liverpool, UK.
Corresponding author: Peter M.A. Calverley (pmacal@liverpool.ac.uk)
@ERSpublications
COPD still causes substantial morbidity and mortality in millions of people around the world. This
Monograph outlines our growing understanding of COPD and highlights the cutting edge of research and care
for this common illness. https://bit.ly/ERSM103intro
Copyright ©ERS 2024. Print ISBN: 978-1-84984-175-7. Online ISBN: 978-1-84984-176-4. Print ISSN: 2312-508X. Online
ISSN: 2312-5098.
COPD remains a major cause of ill health, disability, healthcare costs and premature mortality.
This is not due to lack of effort on the part of clinicians and scientists. In 1950, 76 new papers
were published that used the term chronic obstructive pulmonary disease, 76 that used the term
emphysema and 13 that used the term chronic bronchitis. By 1980, the numbers had risen to 350,
255 and 32, respectively. In 2020, 6024 papers were published using the now preferred term,
COPD. Even allowing for duplicate publication in different languages, this represents a significant
effort across many countries to understand this important respiratory disease and it has yielded
positive results. As we reach the “other side” of the COVID-19 pandemic and old concerns begin
to reassert themselves in our clinical practice, it feels like an appropriate time to take stock of
where we are in the long struggle against COPD and consider what the future might bring.
That is what we have tried to do in this issue of the ERS Monograph. We begin at the heart of
the matter, with the patient’s perspective on COPD [1]. This may make for uncomfortable
reading as it is clear that despite our best efforts, we are still falling short of our patients’
rightful expectations. Next we survey our progress up to the time just before the pandemic
began, considering how our understanding of COPD has evolved and how it has been driven by
prevailing medical concepts. The tools available to interrogate the illness and insight provided
by the results of therapeutic trials, which were not always successful, are also considered [2].
Defining COPD has been a recurring problem, which has limited our understanding
considerably. This topic is addressed in detail in chapter 3 [3]. A particular challenge for both
patients with COPD and their carers is the long and variable time-course of this condition. With
the advent of large datasets, in which spirometry data have been collected in population
samples, multiple disease trajectories have been identified. This complex but important topic is
reviewed in chapter 4 [4]. Changes in the incidence and prevalence of COPD, perhaps reflecting
its multifactorial origins, are reviewed in chapter 5 [5]. Clinical COPD is characteristically
accompanied by multimorbidity, with some conditions sharing common mechanistic pathways
with COPD. One of the most frequent and important of these is cardiac disease, and this is the
topic of chapter 6 [6].
https://doi.org/10.1183/2312508X.10035423 xi
Jadwiga A. Wedzicha1,2, James P. Allinson1,2 and Peter M.A. Calverley 3
1 Royal Brompton Hospital, London, UK. 2 National Heart and Lung Institute, Imperial College London, London, UK.
3 University of Liverpool, Liverpool, UK.
Corresponding author: Peter M.A. Calverley (pmacal@liverpool.ac.uk)
@ERSpublications
COPD still causes substantial morbidity and mortality in millions of people around the world. This
Monograph outlines our growing understanding of COPD and highlights the cutting edge of research and care
for this common illness. https://bit.ly/ERSM103intro
Copyright ©ERS 2024. Print ISBN: 978-1-84984-175-7. Online ISBN: 978-1-84984-176-4. Print ISSN: 2312-508X. Online
ISSN: 2312-5098.
COPD remains a major cause of ill health, disability, healthcare costs and premature mortality.
This is not due to lack of effort on the part of clinicians and scientists. In 1950, 76 new papers
were published that used the term chronic obstructive pulmonary disease, 76 that used the term
emphysema and 13 that used the term chronic bronchitis. By 1980, the numbers had risen to 350,
255 and 32, respectively. In 2020, 6024 papers were published using the now preferred term,
COPD. Even allowing for duplicate publication in different languages, this represents a significant
effort across many countries to understand this important respiratory disease and it has yielded
positive results. As we reach the “other side” of the COVID-19 pandemic and old concerns begin
to reassert themselves in our clinical practice, it feels like an appropriate time to take stock of
where we are in the long struggle against COPD and consider what the future might bring.
That is what we have tried to do in this issue of the ERS Monograph. We begin at the heart of
the matter, with the patient’s perspective on COPD [1]. This may make for uncomfortable
reading as it is clear that despite our best efforts, we are still falling short of our patients’
rightful expectations. Next we survey our progress up to the time just before the pandemic
began, considering how our understanding of COPD has evolved and how it has been driven by
prevailing medical concepts. The tools available to interrogate the illness and insight provided
by the results of therapeutic trials, which were not always successful, are also considered [2].
Defining COPD has been a recurring problem, which has limited our understanding
considerably. This topic is addressed in detail in chapter 3 [3]. A particular challenge for both
patients with COPD and their carers is the long and variable time-course of this condition. With
the advent of large datasets, in which spirometry data have been collected in population
samples, multiple disease trajectories have been identified. This complex but important topic is
reviewed in chapter 4 [4]. Changes in the incidence and prevalence of COPD, perhaps reflecting
its multifactorial origins, are reviewed in chapter 5 [5]. Clinical COPD is characteristically
accompanied by multimorbidity, with some conditions sharing common mechanistic pathways
with COPD. One of the most frequent and important of these is cardiac disease, and this is the
topic of chapter 6 [6].
https://doi.org/10.1183/2312508X.10035423 xi