Updates in the management of stable chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease state characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory process. It is increasingly recognized as a major public health problem, affecting more than 20 million adults in the US. It is also recognized as a leading cause of hospitalizations and is the fourth leading cause of death in the US. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) operates to promote evidence-based management of COPD, increase awareness and encourage research. In 2011, GOLD published a consensus report detailing evidence-based management strategies for COPD, which were last updated in 2015. In recent years, newer strategies and a growing number of new pharmacologic agents to treat symptoms of COPD have also been introduced and show promise in improving the management of COPD. We aim to provide an evidence-based review of the available and upcoming pharmacologic and non-pharmacologic treatment options for stable COPD, with continued emphasis on evidence-based management.

No Independent Influence of Statins on the Chronic Obstructive Pulmonary Disease Exacerbation Rate: A Cohort Observation Study Over 10 Years

“… 7 , 8 According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), COPD is a preventable and treatable disease of the airways that is associated with a restriction in airflow. 9 The disease is progressive and associated with a chronic inflammatory response of the lungs to harmful particles or gases. 9 There have been different study results published in the medical literature thus far.…”

“… 9 The disease is progressive and associated with a chronic inflammatory response of the lungs to harmful particles or gases. 9 There have been different study results published in the medical literature thus far. According to an analysis published in the New England Journal of Medicine, statins have no effect on the exacerbation rate of COPD.…”

Effect of Liuweibuqi capsules on CD4+CD25+Foxp3+ regulatory T cells, helper T cells and lung function in patients with stable chronic obstructive pulmonary disease complicated with lung Qi deficiency

“…Smoking may directly destroy the balance of pro-inflammatory and anti-inflammatory response via inhibiting CD8 + T cell/ CD8 + Tregs action (42). Cigarette cessation has been proved to be the most successful and cost-effective regimen for suppressing disease progression (43). Lung functions is generally determined by FEV1 (%), and low FEV1 in early adulthood is regarded as the genesis of COPD (44,45).…”

What have we learned from observational studies and clinical trials of mild to moderate COPD?

“…Encouragement of smoking cessation, in conjunction with management of symptoms and treating activity limitations and exacerbations by appropriate pharmacologic and non-pharmacologic management at the earliest possible stage can positively affect the impact and progression of the disease [ 9 ]. In recent years, newer strategies and a growing number of new pharmacologic agents to treat COPD have also been introduced and show promise in improving the management of COPD [ 10 ]. New disease lung models to predict patient-specific drug deposition are also being developed in order to individualise therapy [ 11 ].…”