Book Review

Chronic Obstructive Pulmonary Disease

N Engl J Med 2007; 357:2210November 22, 2007

Article

Chronic Obstructive Pulmonary Disease
Edited by Robert Stockley, Stephen Rennard, Klaus Rabe, and Bartolome Celli. 892 pp., illustrated. Malden, MA, Blackwell, 2007. $264.95. ISBN: 978-1-4051-2289-4

The prevalence, morbidity, and mortality of chronic obstructive pulmonary disease (COPD) have increased to the extent that the World Health Organization estimates that COPD is now the fourth leading cause of death worldwide. Approximately 3 million deaths each year are caused by COPD. Patients require frequent hospitalization, making it a costly disease with an extremely high socioeconomic burden. Not long ago, physicians had a nihilistic view of treatment, but this view has changed recently and the current definition characterizes the disease as preventable and treatable.

Chronic Obstructive Pulmonary Disease was edited by a group of distinguished scientists. It contains 70 chapters that are divided among seven sections. The book begins with a discussion of physiology and continues with chapters on allied conditions, host defenses and inflammation, pathogenesis, clinical considerations and complications, current and future treatments, and pharmacotherapy and other developing therapies.

The strength of the book lies in the more than 100 authors, most from the United States or Europe, who are recognized worldwide. Most of the chapters are excellent reviews and are carefully referenced, but unfortunately not all contain a summary or a section listing the key points. Some of the authors are employees of pharmaceutical companies, but I consider their chapters dealing with drugs to be rather neutral. Like any multiauthored book, this one has writing styles that vary widely, and a number of points are repeated on several occasions.

A major weakness of the book is the order of the chapters. One has to read until page 167 to find a definition of COPD, the chapter on smoking cessation comes after the chapter on long-term invasive mechanical ventilation, and “Surgical Therapy for COPD” (chapter 55) precedes the three chapters on medical treatment (chapter 56, “Anticholinergics in COPD”; chapter 57, “β₂-Agonists”; and chapter 58, “Corticosteroids”). In addition, the section titles do not always correspond to the chapters that are contained in the sections. For example, chapter 64, “Economic Burden of COPD,” is in the section called “Current and Future Treatment.” The color plates appear in the middle of chapter 31 without warning, causing confusion. There is no chapter on epidemiology, nor are there chapters on pulmonary hypertension or cor pulmonale.

The strength of the work lies in the chapters themselves, and I would advise the reader to consult individual chapters without regard for the order in which they appear. The tables and figures are useful, and they summarize information and illustrate difficult issues clearly. The book emphasizes the research side of COPD, rather than the clinical aspects; it also demonstrates the lack of knowledge about many aspects of the disease and the need for further research. For these reasons, it is a very useful contribution to the scientific literature.

Nikos Siafakas, M.D., Ph.D.
University of Crete Medical School, 71110 Heraklion, Crete, Greece
siafak@med.uoc.gr

Citing Articles (1)

Citing Articles

1. 1

   Arvind Chopra, Manjit Saluja, Vaijayanti Lagu-Joshi, Sanjiv Sarmukadam. (2008) Leflunomide (Arava™) is a useful DMARD in Indian (Asian) patients: a clinic-based observational study of 1-year treatment. Clinical Rheumatology 27:8, 1039-1044
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