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Influencing the decline of lung function in COPD: use of pharmacotherapy

Authors Ekaterina S Gladysheva, Atul Malhotra, Robert L Owens

Published 17 May 2010 Volume 2010:5 Pages 153—164

DOI https://doi.org/10.2147/COPD.S4577

Review by Single-blind

Peer reviewer comments 3

Ekaterina S Gladysheva1, Atul Malhotra2, Robert L Owens2

1Harvard Combined Pulmonary and Critical Care Fellowship, Harvard Medical School, Boston, MA, USA; 2Pulmonary and Critical Care and Sleep Divisions, Brigham and Women’s Hospital, MA, USA

Abstract: Chronic obstructive pulmonary disease (COPD) is a common and deadly disease. One of the hallmarks of COPD is an accelerated decline in lung function, as measured by spirometry. Inflammation, oxidative stress and other pathways are hypothesized to be important in this deterioration. Because progressive airflow obstruction is associated with considerable morbidity and mortality, a major goal of COPD treatment has been to slow or prevent the accelerated decline in lung function. Until recently, the only known effective intervention was smoking cessation. However, newly reported large clinical trials have shown that commonly used medications may help slow the rate of lung function decline. The effect of these medications is modest (and thus required such large, expensive trials) and to be of clinical benefit, therapy would likely need to start early in the course of disease and be prolonged. Such a treatment strategy aimed at preservation of lung function would need to be balanced against the side effects and costs of prolonged therapy. A variety of newer classes of medications may help target other pathophysiologically important pathways, and could be used in the future to prevent lung function decline in COPD.

Keywords: COPD, emphysema, pulmonary function, beta-agonist, anti-inflammatory, pharmacotherapy in COPD

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