# Whole lung directed anti-muscarinic therapy improves small airway dysfunction in COPD patients

## TL;DR

Targeting anti-muscarinic therapy to the whole lung improves small airway function in COPD patients, offering better symptom management.

## Contribution

This study highlights the importance of targeting small airway dysfunction in COPD with localized therapy.

## Key findings

- Small airway dysfunction is prevalent in COPD and correlates with symptoms.
- Directed anti-muscarinic therapy improves lung function in affected regions.

## Abstract

Small airway disease is a key feature of COPD that often precedes emphysema, with the small airways representing a major site of airflow limitation [1]. The prevalence of small airway dysfunction (SAD) ranges from 50% to 90% in COPD patients, and correlates with symptoms [2]. SAD is usually well-established before conventional spirometry is abnormal [3], and contributes to patient quality-of-life burden [4] and disease exacerbations [5].

Directed distribution of inhaled therapy to diseased lung regions improves patient lung function. Small airway disease should be considered a treatable trait and actively sought in the clinic, leading to targeting therapeutic treatment to this region.
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