In the Feb. 1 issue of the American Journal of Respiratory and Critical Care Medicine, Mark T. Dransfield and colleagues report that among 2,000 participants enrolled in the COPDGene study, exacerbations are associated with accelerated lung function loss in subjects with established COPD.

Over five years, the loss was greatest among participants classified as GOLD 1 patients: each exacerbation in this group was associated with an additional 23mL/year decline in FEV1.

In addition to this novel finding, the authors report that severe exacerbations also resulted in greater lung function decline.

The study findings raise the possibility that preventing exacerbations in those with mild disease “could reduce the risk of developing severe COPD, an important hypothesis that should motivate randomized trials.”

Peter M. A. Calverley wrote an accompanying editorial.