COPD

Associations of anxiety and depression with prognosis in chronic obstructive pulmonary disease: A systematic review and meta-analysis.

Wu K, Lu L, Chen Y, Peng J, Wu X, Tang G · Pulmonology · 2025

The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge

Meta-analysis of the adjuvant treatment of COPD with Erchen Decoction.

Gao X, Lv X, Dong W, Zhang L, Zuo J · Medicine · 2025 · n=758

To systematically evaluate the effect of the adjuvant treatment of Chronic obstructive pulmonary disease with Erchen Decoction, exploring its potential in alleviating clinical symptoms and improving patients' quality of life. Two independent evaluators conducted a computerized search of databases including CNKI, Wanfang, VIP, EMBase, Scopus, Web of Science, PubMed, and Cochrane Library. The search aimed to collect randomized controlled trials on Erchen Decoction as an adjuvant treatment for Chronic Obstructive Pulmonary Disease, spanning from the database inception to September 2024, and also traced references within the retrieved literature. Following trial selection and information extraction, they assessed the methodological quality. RevMan 5.3 software was utilized for Meta-analysis, while the Cochrane system evaluated the evidence quality. A total of 758 participants were enrolled. Baseline comparisons between the 2 groups showed no statistically significant differences (all P&#

Impact of exercise training on cognitive function in patients with COPD: a systematic review and meta-analysis of randomised controlled trials.

Ding K, Song F, Sun W, Sun M, Xia R · European respiratory review : an official journal of the European Respiratory Society · 2025

The aim of this study was to describe the characteristics of exercise therapies in randomised controlled trials (RCTs) targeted at improving cognitive function and to assess their efficacy in COPD. We conducted a comprehensive search of eight databases, namely PubMed, Web of Science, Embase, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Weipu, covering the period from database construction to 23 April 2024. Our search specifically targeted RCTs studying the effects of exercise on cognitive functioning in COPD patients. Trials consisted of one or more exercise training interventions along with at least one cognitive outcome study. Two reviewers independently reviewed papers, extracted data and evaluated the research literature's quality using the Cochrane risk-of-bias assessment tool RoB 2.0 and the modified Jadad scale. Meta-analysis of Montreal Cognitive Assessment (MoCA) scores in the groups with and without exercise i

Efficacy and Safety of Acupuncture in Managing COPD: An Overview of Systematic Reviews.

Zeng Q, Liu L, Chen Y, Chen D, Zhou Z, Hu W · International journal of chronic obstructive pulmonary disease · 2024

Acupuncture has been used as an adjuvant therapy for Chronic obstructive pulmonary disease (COPD). However, systematic reviews (SRs) and meta-analyses (MAs) have reported inconsistent results and unknown quality. This overview aimed to summarize the current SRs/MAs to provide evidence for the effectiveness and safety of acupuncture in the treatment of COPD. SRs/MAs were searched via eight databases from their establishment to December 31, 2023. The methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The risk of bias was assessed using the Risk of Bias in Systematic Review (ROBIS) tool. The Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A) to evaluate the reporting quality. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to determine the strength of evidence. In addition, we also conducted an analysis of the acupuncture points used in the primary RCTs. Tw

Spiritual Care within Dietetic Practice: A Systematic Literature Review.

Lycett D, Patel R · Journal of religion and health · 2023

Registered dietitians assess, diagnose and treat nutritional problems. Although integral to healthcare, their role in spiritual care is unknown. We conducted a systematic review of spiritual needs and spiritual care in nutrition and dietetic practice. Subject Headings and keywords were used to search Medline, CINAHL, PsycINFO and AMED for studies exploring spiritual care and nutrition or dietetic practice. From 1433 records, 13 studies were included. Medium quality evidence showed unmet spiritual needs among dietetic patients suffering from cancer, COPD, heart failure and diabetes. Unmet needs occurred in patients from a variety of ethnicities, religions and none. However, dietitians were only involved in spiritual care regarding nutrition and hydration at the end of life. Integrating spiritual screening and sign-posting within dietetic practice is prudent, but clinical trials are needed to evaluate its effectiveness.

Nutrition as a modifiable factor in the onset and progression of pulmonary function impairment in COPD: a systematic review.

van Iersel LEJ, Beijers RJHCG, Gosker HR, Schols AMWJ · Nutrition reviews · 2022

Chronic obstructive lung disease (COPD) is a progressive lung disease characterized by persistent airflow limitation. An increasing amount of evidence suggests an effect of dietary quality on the risk of COPD in the general population and pulmonary function decline in patients with COPD. The association of dietary intake and nutrient status with COPD risk and onset, as well as pulmonary function decline (change in forced expiratory volume in 1 second, forced vital capacity, or the ratio of the former to the latter) in patients with COPD was investigated in this systematic review. The PubMed database was searched by combining terms of pulmonary function or COPD with diet, nutrient status, or nutritional supplementation. Original studies and systematic reviews and meta-analyses were included. Articles obtained were independently screened for relevance on the bases of title and abstract by 2 researchers. Eventually, 89 articles were included in the analysis. The unhealthy Weste

Pocket guide: biologics in upper and lower airways in adults.

Fokkens WJ, Backer V, Lund VJ, Barnes PJ, Bernal-Sprekelsen M, Bjermer L · Rhinology · 2025

The introduction of biologics for the treatment of severe upper and lower (type 2) airway inflammation has been a game changer in the management of these diseases. Biologics are injectable medications targeting different molecules relevant in (type 2) inflammation in patients with severe (type 2) airway diseases, like asthma, eosinophilic chronic obstructive pulmonary disease (COPD), chronic rhinosinusitis (CRS) and those who remain uncontrolled despite regular treatment. After the phase 3 trials, showing significant impact on symptoms, quality of life and interventions like surgery (for the upper airways) and exacerbations needing hospitalisation (for the lower airways), biologics are now used in daily practice in many parts of the world. This pocket guide is aimed at all specialists treating adult patients with severe airway disease.

[Guidelines for the prevention and management of bronchial asthma (2024 edition)].

Chinese Thoracic Society, Chinese Medical Association · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases · 2025

Bronchial asthma (asthma) is a common chronic respiratory disease. Standardized diagnosis, treatment and effective clinical management are critical to improving asthma control, improving patients' quality of life, and reducing the disease burden. Based on the latest evidence-based research from both domestic and international references, the Asthma Group of the Chinese Thoracic Society has revised the "Guidelines for bronchial asthma prevent and management (2020 edition)". This revision supplements the diagnostic pathway, and updates clinical staging, and severity grading of asthma. Furthermore, adjustments have been made in asthma evaluation, maintenance therapy, acute exacerbation management, severe asthma, atypical asthma, and treatment principles of asthma, according to the latest research evidence. The updated guideline serves as a comprehensive resource for healthcare professionals in China, providing the latest recommendations to improve their knowledge and competence in the sta

GOLD Science Committee recommendations for the use of pre- and post-bronchodilator spirometry for the diagnosis of COPD.

Singh D, Stockley R, Anzueto A, Agusti A, Bourbeau J, Celli BR · The European respiratory journal · 2025

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) report states that the diagnosis of COPD should be considered in individuals with chronic respiratory symptoms and/or exposure to risk factors. Forced spirometry demonstrating airflow obstruction after bronchodilation is required to confirm the diagnosis using a threshold of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7. This GOLD Science Committee review weighs the evidence for using pre- or post-bronchodilator (BD) spirometry to diagnose COPD. Cohort studies have shown that pre- and post-BD spirometry give concordant diagnostic results in most cases, although the prevalence of COPD is up to 36% lower with post-BD values. Discordant results may occur in "volume" or "flow" responders. Volume responders have reduced FVC due to gas trapping causing FEV1/FVC ≥0.7 pre-BD, but a volume response occurs post-BD with a greater improvement in FVC relative to FEV1 decreasing the rat

Vitamin D Supplementation, Chronic Obstructive Lung Disease and Asthma Exacerbations, and Lung Function Decline.

Gold DR, Carey VJ, Hersh CP, Wan E, Camargo CA Jr, Lee IM · The Journal of nutrition · 2025 · n=1648

It remains unclear whether supplementation with vitamin D reduces risk of acute exacerbations of chronic obstructive lung disease (COPD) or asthma, major contributors to the world-wide burden of disease. To compare effects of vitamin D with placebo supplementation for the prespecified primary endpoints 1) acute exacerbations of COPD and 2) decline in pulmonary function measures of airflow obstruction. Prespecified secondary endpoints included asthma exacerbations and control. Lung VITamin D and OmegA-3 TriaL (VITAL) is an ancillary study of VITAL, a United States nationwide, randomized, placebo-controlled trial with a 2-by-2 factorial design of vitamin D3 (2000 IU/d) and marine n-3 fatty acids (1 g/d) among men 50 y and women 55 y of age or older. Of 25,871 randomly divided participants, 3632 at risk for respiratory exacerbations, including 1977 with COPD by diagnosis or symptoms and 1654 with self-reported asthma diagnosis, were followed annually for 5 y by self-administered respira

Effect of acupuncture on patients with chronic obstructive pulmonary disease: A multicenter randomized controlled trial.

Li J, Xie Y, Wang Y, Wu L, Yu X, Bai L · Complementary therapies in medicine · 2025 · n=150

Chronic obstructive pulmonary disease (COPD) is a common and frequently occurring disease that seriously endangers health, causing a heavy economic burden on patients and society. Acupuncture has been reported to have a therapeutic effect on patients with chronic obstructive pulmonary disease (COPD). However, compared with medications, it is difficult to identify a superior therapy. Therefore, the aim of this study was to evaluate the efficacy and safety of acupuncture, conventional drug and acupuncture plus conventional drug in the treatment of COPD. This was a multicenter, open-label randomized controlled trial (RCT) through a central randomization system. A total of 150 COPD patients were randomly assigned at a 1:1:1 ratio to the acupuncture group, conventional drug group or acupuncture plus conventional drug group for 12 weeks of treatment, followed by 12 weeks of untreated follow-up. The primary outcomes included the six-minute walk distance (6MWD) and St. George's Respiratory Qu

Functional and metabolic effects of omega-3 polyunsaturated fatty acid supplementation and the role of β-hydroxy-β-methylbutyrate addition in chronic obstructive pulmonary disease: A randomized clinical trial.

Engelen MPKJ, Simbo SY, Ruebush LE, Thaden JJ, Ten Have GAM, Harrykissoon RI · Clinical nutrition (Edinburgh, Scotland) · 2024

Short-term (4 weeks) supplementation with n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has recently been shown to improve protein metabolism in a dose dependent way in normal weight patients with Chronic Obstructive Pulmonary Disease (COPD). Furthermore, EPA/DHA supplementation was able to increase extremity lean soft tissue but not muscle function. No studies are available combining n-3 PUFAs and the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) supplementation in chronic clinical conditions. Whether adding HMB to daily EPA/DHA supplementation for 10 weeks enhances muscle and brain health, daily functional performance, and quality of life of patients with COPD by further improving their protein and amino acid homeostasis remains unknown. Patients with COPD (GOLD: II-IV, n = 46) received daily for 10 weeks, according to a randomized double-blind placebo-controlled three-group design, EPA/DHA (n = 16),

Associations of socioeconomic status and health lifestyles with chronic obstructive pulmonary disease: two nationwide population-based studies.

Liu S, Liu T, Lu C, Guo J, Li J, Wang H · BMC public health · 2025

Low socioeconomic status (SES) is associated with increased chronic obstructive pulmonary disease (COPD) risk, with smoking and poor diet as major contributing factors. However, the impact of a comprehensive healthy lifestyle as a potential mediator between SES and COPD risk remains understudied. This study analyzed data from 32,836 US adults in the NHANES (1999-2020) and 131,872 UK adults in the UK Biobank. SES was assessed via latent class analysis based on income, education, employment, and health insurance (NHANES). SES was categorized into high, middle, and low levels. Healthy lifestyle scores included nonsmoking, no heavy drinking, regular physical activity, and a high-quality diet. Weighted multivariable logistic regression (NHANES) and Cox proportional hazards models (UK Biobank) were used to assess the associations between SES and the prevalence (NHANES) or incidence (UK Biobank) of COPD. In the UK Biobank, the incidences of newly diagnosed COPD in the high-, medium-, and lo

The Role and Clinical Significance of Vitamin D in Chronic Obstructive Pulmonary Disease.

Sun M, Qian Y, Cai C, Zhang J, Qi R, Ma H · International journal of chronic obstructive pulmonary disease · 2025

Vitamin D is well known for its role in bones, but it also has a variety of extra-skeletal effects. Vitamin D deficiency is becoming a global health problem. Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world, resulting in an enormous medical and economic burden. Accumulating evidence indicates a high prevalence of vitamin D deficiency in patients with COPD, which has emerged as a significant modulator of disease progression. This comprehensive review systematically examines the multifactorial etiology of vitamin D deficiency in COPD, encompassing insufficient sunlight exposure, malnutrition, smoking, comorbidities, and chronic inflammatory states. Clinical observational studies have demonstrated significant associations between vitamin D deficiency and increased exacerbation frequency, accelerated lung function decline, and elevated mortality risk. Mechanistically, we elucidate the pleiotropic effects of vitamin D in COPD pathogenesis, includ

A hypothetical intervention analysis for the effects of healthy dietary patterns on reducing major chronic diseases and mortality associated with air pollutant mixtures.

Zheng G, Chen L, Ran S, Wei S, Ho KF, Huang Z · BMC medicine · 2025

Randomized trials have not assessed how changing dietary patterns affects air pollution-related chronic diseases and mortality. We estimated these risks under hypothetical dietary interventions. 17,254 UK Biobank adults with repeated 24-h dietary assessments (2009-2012) were included. Exposures to six air pollutants (PM2.5, PM10, NO2, NOX, SO2, and benzene) were estimated using the bilinear interpolation algorithm. Outcomes included incident cardiovascular disease (CVD), diabetes, cancer, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), dementia, and all-cause mortality. Eleven dietary patterns were calculated. Using the parametric g-formula, we simulated interventions increasing dietary scores (75th/90th percentiles, optimal adherence), estimating 13-year cumulative risks and risk difference (RD) for outcomes associated with air pollutant mixtures. Over 12.9 median follow-up years, 2295 CVD, 475 diabetes, 1912 cancer, 969 CKD, 395 COPD, 405 dementia cases,

COPD

CDC

The CDC provides comprehensive information on COPD, including facts, symptoms, risk factors, diagnosis, treatment, and living with the condition, aimed at the general public and healthcare professionals.

Chronic respiratory diseases

WHO

Provides an overview of chronic respiratory diseases, including COPD, detailing their impact, risk factors, and WHO's efforts in prevention and control.

Non-interventional Study for Documentation of the Therapeutic Efficacy, Use and Tolerance of the Fixed-Dose Combinations (FDC) Duaklir® Genuair® (Aclidinium/Formoterol), Ultibro® Breezhaler® (Glycopyrronium/Indacaterol) and Anoro® (Umeclidinium/Vilanterol) in the Treatment of COPD Under Real Conditions in the Practices of Pneumologists, Internists, and General Practitioners

n=3732 · NCT02552160 · COMPLETED · COMPLETED

Prospective, multi-centre, non-interventional study to collect findings about the effects of LABA/LAMA (Long Acting Beta2-Agonists / Long Acting Muscarinic Antagonists) combination preparations on COPD (Chronic obstructive pulmonary disease) symptoms and quality of life under real conditions and to find out what types of patients are selected for this therapy by physicians.

Study DB2116961, A Multicentre, Randomised, Blinded, Parallel Group Study to Compare UMEC/VI (Umeclidinium/Vilanterol) in a Fixed Dose Combination With Indacaterol Plus Tiotropium in Symptomatic Subjects With Moderate to Very Severe COPD

n=967 · NCT02257385 · COMPLETED · COMPLETED

This is a Phase IIIb multicentre, randomised, blinded, triple dummy, parallel group study to evaluate the efficacy and safety of UMEC/VI inhalation powder (62.5/25 microgram \[mcg\] Once daily \[QD\]) when administered via ELLIPTA® Dry Powder Inhaler (DPI) compared to indacaterol plus tiotropium (150 mcg/18 mcg respectively QD) administered via individual inhalers over a treatment period of 12 weeks in participants with moderate to very severe Chronic Obstructive Pulmonary Disease (COPD). The purpose of this study is to demonstrate that UMEC/VI (delivered via ELLIPTA DPI), when used in symptomatic moderate to very severe COPD participants, is non-inferior to the combination of indacaterol (delivered via BREEZHALER® inhaler) plus tiotropium (delivered via HANDIHALER® inhaler) on measures of trough forced expiratory volume in one second (FEV1) after 12 weeks of treatment. Participants who met the eligibility criteria at screening (Visit 1) will complete a 5 to 7 day run in period prior to randomisation at Visit 2. Clinic visits will follow at day 2, week 2, week 4, week 8 and week 12 of treatment, plus week 12 + 1 day (Visits 3 to 8). The total duration of study participation will be approximately 14 weeks. ELLIPTA is a registered trademark of the GSK group of companies. HANDIHALER is a registered trademark of Boehringer Ingelheim Pharma GmbH \& Co. KG. BREEZHALER is a registered trademark of Novartis AG.

Efficacy of an Education Protocol in the Correction of Inhalation Techniques in Patients With Chronic Obstructive Pulmonary Disease

n=61 · NCT03144557 · COMPLETED · COMPLETED

This study evaluates the implementation of an education protocol and its impact on the correct inhalation technique in COPD patients presenting errors or mistakes. There will be 4 sessions, in each one the inhalation technique will be evaluated using a checklist of steps. Whenever errors are found, the correct use of each device will be educated through verbal explanation and written material will be delivered.

Cochrane Airways

Cochrane

Cochrane Airways publishes systematic reviews of interventions for airways diseases, including COPD, providing high-quality, independent evidence to inform healthcare decisions.

Cochrane reviews on COPD

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses on various interventions and aspects related to COPD, offering high-quality evidence to inform healthcare decisions.