Limitations of current treatment: unmet needs in the treatment of COPD

In the last few years, considerable interest has been aroused in the treatment of chronic obstructive pulmonary disease (COPD) and the dearth of therapeutic options has been replaced by a far more proactive treatment approach, reflected in the development of the various guidelines and recommendation...

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Veröffentlicht in:Archivos de bronconeumología (English ed.) 2010-12, Vol.46 Suppl 10, p.8-13
Hauptverfasser: de Lucas Ramos, Pilar, López Martín, Soledad, Rodríguez González-Moro, José Miguel
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container_title Archivos de bronconeumología (English ed.)
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Rodríguez González-Moro, José Miguel
description In the last few years, considerable interest has been aroused in the treatment of chronic obstructive pulmonary disease (COPD) and the dearth of therapeutic options has been replaced by a far more proactive treatment approach, reflected in the development of the various guidelines and recommendations of the scientific societies. There are three main steps in the treatment of COPD: prevention of the disease, treatment of its symptoms, progression and complications, and recovery of physical function through respiratory rehabilitation. Considerable advances have been produced in these three dimensions, but limitations have been detected, indicating areas for improvement. The most effective means to prevent the disease is smoking cessation. While there are moderately effective drugs to help individuals quit, no drugs are available to prevent relapses. Moreover, due to health policies, most patients with COPD do not receive drug treatment for smoking. The treatment of COPD and its complications is based on the use of bronchodilators, which improve symptoms and quality of life and, to a greater or lesser extent, prevent exacerbations. However, treatment aimed at the underlying pathogenic causes of the disease, which should be antiinflammatory treatment, remains an unresolved issue due to the discouraging results obtained with inhaled corticosteroids, which should always be used in combination with a bronchodilator. The development of new antiinflammatory agents, such as roflumilast, could improve the management of patients with the most severe disease and repeated exacerbations. Lastly, although respiratory rehabilitation is highly effective in helping patients recover their ability to exercise, few patients have access to this option. As with the treatment of smoking, there is a need to implement respiratory rehabilitation through simple and effective programs and with the support of the health administration.
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However, treatment aimed at the underlying pathogenic causes of the disease, which should be antiinflammatory treatment, remains an unresolved issue due to the discouraging results obtained with inhaled corticosteroids, which should always be used in combination with a bronchodilator. The development of new antiinflammatory agents, such as roflumilast, could improve the management of patients with the most severe disease and repeated exacerbations. Lastly, although respiratory rehabilitation is highly effective in helping patients recover their ability to exercise, few patients have access to this option. 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subjects Adrenal Cortex Hormones - administration & dosage
Adrenal Cortex Hormones - therapeutic use
Airway Obstruction - drug therapy
Airway Obstruction - etiology
Airway Obstruction - physiopathology
Anti-Inflammatory Agents - therapeutic use
Bronchodilator Agents - administration & dosage
Bronchodilator Agents - therapeutic use
Disease Management
Disease Progression
Drug Therapy, Combination
Exercise Tolerance
Health Policy
Health Services Needs and Demand
Humans
Oxidative Stress
Phosphodiesterase 4 Inhibitors - therapeutic use
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Disease, Chronic Obstructive - rehabilitation
Pulmonary Disease, Chronic Obstructive - therapy
Randomized Controlled Trials as Topic
Smoking Cessation
title Limitations of current treatment: unmet needs in the treatment of COPD
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