title: Influencing the decline of lung function in COPD: use of pharmacotherapy.
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.
authors.affiliation: Harvard Combined Pulmonary and Critical Care Fellowship, Harvard Medical School, Boston, MA, USA.
authors.forename: Ekaterina S
authors.initials: ES
authors.lastname: Gladysheva
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
authors.forename: Robert L
authors.initials: RL
authors.lastname: Owens
mesh_terms: D000328:Adult; D000368:Aged; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology*; D012129:Respiratory Function Tests