Where to start when treating COPD?

Abstract

http://onlinelibrary.wiley.com/doi/10.1111/resp.13100/abstract

Year in review 2017: Chronic obstructive pulmonary disease and asthma

“…provided support for starting with a long‐acting inhaled anti‐muscarinic drug as first‐line maintenance therapy in COPD instead of a long‐acting inhaled beta‐agonist. This approach is also advocated by the GOLD 2017 report and discussed in an editorial by Calverley . A systematic review of the impact of inhaled corticosteroid treatment on the risk of lung cancer in COPD by Raymakers et al .…”

“…This approach is also advocated by the GOLD 2017 report and discussed in an editorial by Calverley. 16,31 A systematic review of the impact of inhaled corticosteroid treatment on the risk of lung cancer in COPD by Raymakers et al 32 found that randomized studies demonstrated no evidence of benefit, although descriptive studies showed some protection at high doses. Finally, a prospective cohort study by Shin et al 4 reported post-operative respiratory complications in nearly 25% of COPD patients following extra-pulmonary surgery.…”

Comparative Efficacy of Chinese Herbal Injections for Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Bayesian Network Meta‐Analysis of Randomized Controlled Trials

“…Frequent exacerbations of COPD are associated with increased mortality and AECOPD imposes a huge economic burden on healthcare systems worldwide [ 5 , 6 ]. Although an inhaled bronchodilator is the first choice for treating AECOPD, there is no current consensus on the optimal benefits of pharmacological or nonpharmacological management [ 7 , 8 ]. Recent surveys reported that traditional Chinese medicine is effective in relieving clinical symptoms, improving lung function, reducing inflammation, shortening acute exacerbation, and improving quality of life [ 9 – 12 ].…”