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Personalized medicine for patients with COPD: where are we?
- Source :
- International Journal of Chronic Obstructive Pulmonary Disease. 14:1465-1484
- Publication Year :
- 2019
- Publisher :
- Informa UK Limited, 2019.
-
Abstract
- Chronic airflow limitation is the common denominator of patients with chronic obstructive pulmonary disease (COPD). However, it is not possible to predict morbidity and mortality of individual patients based on the degree of lung function impairment, nor does the degree of airflow limitation allow guidance regarding therapies. Over the last decades, understanding of the factors contributing to the heterogeneity of disease trajectories, clinical presentation, and response to existing therapies has greatly advanced. Indeed, diagnostic assessment and treatment algorithms for COPD have become more personalized. In addition to the pulmonary abnormalities and inhaler therapies, extra-pulmonary features and comorbidities have been studied and are considered essential components of comprehensive disease management, including lifestyle interventions. Despite these advances, predicting and/or modifying the course of the disease remains currently impossible, and selection of patients with a beneficial response to specific interventions is unsatisfactory. Consequently, non-response to pharmacologic and non-pharmacologic treatments is common, and many patients have refractory symptoms. Thus, there is an ongoing urgency for a more targeted and holistic management of the disease, incorporating the basic principles of P4 medicine (predictive, preventive, personalized, and participatory). This review describes the current status and unmet needs regarding personalized medicine for patients with COPD. Also, it proposes a systems medicine approach, integrating genetic, environmental, (micro)biological, and clinical factors in experimental and computational models in order to decipher the multilevel complexity of COPD. Ultimately, the acquired insights will enable the development of clinical decision support systems and advance personalized medicine for patients with COPD.
- Subjects :
- medicine.medical_specialty
COPD
business.industry
Psychological intervention
General Medicine
Disease
medicine.disease
Clinical decision support system
3. Good health
Systems medicine
03 medical and health sciences
0302 clinical medicine
030228 respiratory system
medicine
DECIPHER
030212 general & internal medicine
Personalized medicine
Disease management (health)
Intensive care medicine
business
Subjects
Details
- ISSN :
- 11782005
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- International Journal of Chronic Obstructive Pulmonary Disease
- Accession number :
- edsair.doi...........90f140d52dab90a6a7aa5acd265bae99