PG 2025: Pulmonary Literature Review and Interactive Complex Case Presentations (PG)-MARCINIUK COPD PG Course 2025 YIR Uploaded

MARCINIUK COPD PG Course 2025 YIR Uploaded

Pdf Summary

The 2025 COPD Update, presented by Dr. Darcy D. Marciniuk, provides a comprehensive review of current research and guidelines in COPD management. Key highlights include:

1. <strong>Spirometry and Outcomes:</strong> Spirometry remains the diagnostic gold standard for COPD but is underutilized, with only about 20.9% of patients receiving it at or before treatment initiation. Timely spirometry is linked to significantly reduced mortality and decreased healthcare utilization, emphasizing its importance for all patients starting maintenance respiratory therapy, regardless of smoking status or age.

2. <strong>Alpha-1 Antitrypsin Deficiency (A1ATD):</strong> Updated Canadian Thoracic Society guidelines recommend targeted testing and augmentation therapy. Augmentation therapy shows strong evidence for reducing the rate of lung density deterioration and potentially lowering mortality in patients with severe A1ATD and COPD. Canadian Blood Services provides replacement therapy free for eligible patients meeting criteria including severe deficiency, emphysema, and smoking cessation.

3. <strong>Pulmonary Rehabilitation (PR):</strong> An 8-week PR program has been shown to be generally equivalent to a 12-week program for improving endurance exercise capacity, with some potential additional benefit in the longer program. Despite clear benefits such as improved quality of life and reduced hospitalization, patient participation in PR remains low, highlighting a need to reimagine PR delivery and patient engagement.

4. <strong>Biologic Therapies:</strong> Mepolizumab, an anti-IL-5 monoclonal antibody, significantly reduces moderate to severe exacerbations in COPD patients with an eosinophilic phenotype when added to triple inhaled therapy. Dupilumab is also approved for COPD. However, benralizumab did not reach statistical significance in trials.

In summary, timely spirometry, targeted genetic testing and augmentation in A1ATD, improved pulmonary rehabilitation access, and novel biologic treatments represent important advances in COPD care leading to better patient outcomes.

Keywords

COPD management

spirometry

alpha-1 antitrypsin deficiency

augmentation therapy

pulmonary rehabilitation

biologic therapies

mepolizumab

dupilumab

eosinophilic COPD

Canadian Thoracic Society guidelines