People with mild COPD showed a severe loss of lung function after an acute flare, according to a study, which suggests drugs that prevent exacerbation may be needed to slow the disease.

A clinical trial (NCT00608764) had enrolled more than 10,000 people, both with and without COPD, to study genetic factors linked to the disease in smokers and former smokers. The current study analyzed data from 2,000 participants who took part in a follow-up visit five years after the trial’s start. During the five years, researchers collected data every six months.

Participants were stratified according to their COPD severity, using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. In addition, researchers identified those with a mild decrease in lung function who did not qualify for a COPD diagnosis.

The study found that among COPD patients and those with mild lung impairment, 36.7 percent experienced an acute worsening during those five years. Acute worsening or acute respiratory disease was defined as a state needing treatment with either antibiotics or steroid drugs, while severe exacerbations required hospitalization.

The largest decline in lung function after a disease exacerbation was seen in those with the mildest disease, representing GOLD stage 1. Lung function decline was measured using FEV1, which is the amount of air a person can forcibly exhale in one second.

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