PG 2025: Pulmonary Literature Review and Interactive Complex Case Presentations (PG)-MARCINIUK COPD 2025 PG Pre Post Questions

MARCINIUK COPD 2025 PG Pre Post Questions

Pdf Summary

This pulmonary literature review focuses on two key aspects of COPD management: the role of spirometry and the use of mepolizumab for reducing exacerbations in high-risk patients.<br /><br />First, timely spirometry testing—conducted before or at the start of maintenance respiratory medications—has significant benefits. Spirometry helps identify undiagnosed COPD, which affects 75% of COPD patients and is linked to poorer quality of life and greater healthcare utilization. Studies show targeted spirometry in symptomatic, at-risk individuals reduces respiratory symptoms, healthcare usage, and importantly, mortality. Despite primary care providers diagnosing 80% of COPD cases, they only order 5% of spirometry tests, highlighting a clinical gap. Implementing spirometry around medication initiation lowers mortality risk over a follow-up of 1.7 years, underscoring its critical role in early COPD management (Dehondt et al., CHEST 2025).<br /><br />Second, mepolizumab, an anti-eosinophilic biologic, has demonstrated efficacy for COPD patients at high exacerbation risk with an eosinophilic phenotype. Specifically, in patients aged 40 or older with an FEV1 between 20-80% post-bronchodilator and blood eosinophil counts of 300 cells/µL or higher, adding mepolizumab to triple inhaled therapy (LAMA/LABA/ICS) over 104 weeks significantly reduced the rate of moderate or severe exacerbations. Side effects were comparable to placebo, confirming safety. Mepolizumab is now approved alongside dupilumab for reducing exacerbations in eosinophilic COPD patients receiving triple therapy (Scuirba et al., NEJM 2025).<br /><br />In summary, timely spirometry improves diagnostic accuracy and patient outcomes in COPD, while mepolizumab offers a novel targeted treatment to reduce exacerbations in eosinophilic phenotype COPD when used with standard inhaled triple therapy.

Keywords

COPD management

spirometry testing

undiagnosed COPD

healthcare utilization

mortality risk

primary care diagnosis

mepolizumab

eosinophilic phenotype

triple inhaled therapy

exacerbation reduction