New drugs and treatment strategies in COPD

Despite the fact that COPD is irreversible, a number of pharmacological treatments improve the symptoms and quality of life of patients with COPD. These include bronchodilators (betaagonists, anticholinergics, and theophylline), anti-inflammatory drugs (corticosteroids) and combination products (dual-action bronchodilators and bronchodilator/anti-inflammatory combinations), reducing the number and severity of exacerbations and increasing exercise tolerance. However, the most important aspect of managing COPD in patients of all severities remains smoking cessation, as it is the only variable that has an effect on the decline in lung function. Combining different classes of bronchodilators may improve efficacy and decrease the risk of side effects compared to increasing the dose of a single bronchodilator. Inhaled corticosteroids (ICS) are the main anti-inflammatory class of drugs used to treat COPD. Though the use of ICS is believed to reduce the rate at which health status declines, the ability of ICS to reduce mortality in patients with COPD remains controversial. Evidence from recent clinical trials indicates that triple therapy, combining an anticholinergic with an inhaled corticosteroid and a long-acting beta(2)-agonist, may provide clinical benefits additional to those associated with each treatment alone in patients with more severe COPD. A variety of new drugs are currently under investigation: roflumilast is the first-in-class drug and also the first oral anti-inflammatory treatment for COPD patients, it is a once-daily oral phosphodiesterase (PDE) 4 inhibitor developed for the treatment of COPD associated with chronic bronchitis. Glycopyrrolate is a long-acting muscarinic agent and is intended to launch as a once-daily monotherapy for COPD and also in combination with indacaterol, a long-acting beta2-agonist.

COPD - Atemwegserkrankungen - Pharmakologie - Medikamentöse Therapie - Arzneimittelversorgung - Therapieinnovation