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Review
. 2006;1(4):409-23.
doi: 10.2147/copd.2006.1.4.409.

Pharmacological treatment of chronic obstructive pulmonary disease

Paolo Montuschi  1
Affiliations
Review

Pharmacological treatment of chronic obstructive pulmonary disease

Paolo Montuschi. Int J Chron Obstruct Pulmon Dis. 2006.

Abstract

None of the drugs currently available for chronic obstructive pulmonary disease (COPD) are able to reduce the progressive decline in lung function which is the hallmark of this disease. Smoking cessation is the only intervention that has proved effective. The current pharmacological treatment of COPD is symptomatic and is mainly based on bronchodilators, such as selective beta2-adrenergic agonists (short- and long-acting), anticholinergics, theophylline, or a combination of these drugs. Glucocorticoids are not generally recommended for patients with stable mild to moderate COPD due to their lack of efficacy, side effects, and high costs. However, glucocorticoids are recommended for severe COPD and frequent exacerbations of COPD. New pharmacological strategies for COPD need to be developed because the current treatment is inadequate.

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Figures

Figure 1
Figure 1
Rate of decline in forced expiratory volume in one second (FEV1) after administration of placebo or inhaled glucocorticoids in four randomized controlled multicenter clinical trials: Copenhagen City Lung Study (CCLS), European Respiratory Society study On Chronic Obstructive Pulmonary disease (EUROSCOP), Inhaled Steroids in Obstructive Lung Disease (ISOLDE), and Lung Health Study 2 (LHS2). Inhaled glucocorticoids did not have a significant effect on the rate of decline in FEV1 in any of the clinical trials.
Figure 2
Figure 2
Pharmacological treatment of stable COPD based on GOLD guidelines. Adapted from GICOPD (2001).
Figure 3
Figure 3
Algorithm for the home treatment of an exacerbation of COPD (adapted from Global Initiative for Chronic Obstructive Lung Disease. 2001. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. National Institutes of Health. National Heart, Lung, and Blood Institute. Publication number 2701).
See this image and copyright information in PMC

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