Chronic obstructive pulmonary disease (COPD) is a heterogenous lung condition characterized by progressive airflow obstruction. Despite advancements in diagnosis and treatment, the disease burden remains high; although clinical trials have shown improvements in outcomes such as exacerbations, quality of life, and lung function, improvement may not be attainable for many patients. For patients who do experience improvement, it is challenging to set management goals given the progressive nature of COPD. We therefore propose disease stability as an appropriate and attainable treatment goal. Other disease areas have developed definitions of no disease activity or remission, which provide relevant information for defining and achieving stability for patients with COPD. Disease stability builds on related concepts already defined in COPD such as clinical control and clinically important deterioration. Current components that could form part of a disease stability definition include exacerbations, health status (including quality of life and symptoms) and lung function. Considerations should be given to intervals over which stability is defined and assessed, appropriate thresholds, and defining a composite. Ensuring a holistic approach, objective measurements and harmonious, clear communication between patients and physicians can further support establishing disease stability. Here we propose a preliminary definition of disease stability, informed by existing research in COPD. Further research will be needed to validate the framework for use in clinical and research settings. Exploring disease stability as a goal, however, is an opportunity to develop and validate an attainable treatment target to advance the standard of care for patients with COPD.

中文翻译：

---

疾病稳定性是可以实现的 COPD 治疗目标吗？


慢性阻塞性肺疾病 （COPD） 是一种以进行性气流阻塞为特征的异质性肺部疾病。尽管诊断和治疗取得了进展，但疾病负担仍然很高;尽管临床试验显示病情恶化、生活质量和肺功能等结果有所改善，但许多患者可能无法获得改善。对于确实有所改善的患者，鉴于 COPD 的进展性，设定管理目标是具有挑战性的。因此，我们建议将疾病稳定性作为合适且可实现的治疗目标。其他疾病领域已经制定了无疾病活动或缓解的定义，这为定义和实现 COPD 患者的稳定性提供了相关信息。疾病稳定性建立在 COPD 中已经定义的相关概念之上，例如临床控制和临床上重要的恶化。当前可能构成疾病稳定性定义一部分的组成部分包括恶化、健康状况（包括生活质量和症状）和肺功能。应考虑定义和评估稳定性的间隔、适当的阈值以及定义复合。确保患者和医生之间采用整体方法、客观测量以及和谐、清晰的沟通，可以进一步支持建立疾病稳定性。在这里，我们根据 COPD 的现有研究提出了疾病稳定性的初步定义。需要进一步的研究来验证该框架在临床和研究环境中的使用。然而，探索疾病稳定性作为一个目标是开发和验证可实现的治疗目标以提高 COPD 患者的护理标准的机会。