CHEST Guidelines-To-Improve-COPD-Care

To-Improve-COPD-Care_chest

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The article "To Improve COPD Care: A New Instrument Is Needed to Assess Dyspnea" by Donald A. Mahler and Sanjay Sethi highlights the significant need for a new tool to evaluate dyspnea, a major symptom of Chronic Obstructive Pulmonary Disease (COPD). Current instruments such as the Medical Research Council (MRC) scale and its variations are widely used but have limitations. The U.S. Food and Drug Administration (FDA) acknowledges the importance of symptom relief in COPD drug development but finds existing assessment tools inadequate for regulatory claims.<br /><br />Addressing dyspnea is crucial as it is the prevailing complaint among COPD patients, affecting daily activities and prompting medical intervention. Despite the acknowledgment that dyspnea relief is a valid treatment aim, the lack of a suitable assessment instrument hampers the development of novel therapies intended specifically for this symptom.<br /><br />The authors argue for a paradigm shift in COPD drug development that focuses on creating new therapies targeting the neurobiology of dyspnea. They mention potential strategies, such as targeting specific respiratory system receptors, utilizing systemic opioids, and exploring innovative treatments like monoclonal antibodies and opioid receptor-based drugs that could alleviate breathlessness without affecting lung function.<br /><br />To facilitate this, the article stresses the need for a new patient-reported outcome (PRO) instrument, developed in alignment with FDA guidelines, to evaluate dyspnea. The experience from developing other COPD assessment tools like the EXACT-PRO and E-RS: COPD offers valuable insights.<br /><br />In conclusion, the authors suggest collaboration among the FDA, academia, industry, and patient groups to develop a valid, reliable, and FDA-accepted tool to assess dyspnea, hence improving patient-focused COPD care. They invite stakeholders to engage in this effort to enhance treatment development for COPD.

Keywords

COPD

dyspnea

assessment tool

Medical Research Council scale

FDA

symptom relief

neurobiology

patient-reported outcome

drug development

monoclonal antibodies