Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Abstract

Summary Chronic obstructive pulmonary disease (COPD) is the internationally preferred term for chronic, progressive lung disorders which are characterised by airflow limitation that is not fully reversible. The symptoms of COPD -including breathlessness, cough, excessive sputum production and reduced muscle tone and muscle wasting -reflect the complex pathophysiology of the disease. In order to address these symptoms, treatment regimens should take into account the multiple components that contribute to COPD. Clinical evidence has emerged indicating that, especially in patients with severe COPD, long-acting beta 2 -agonists (LABAs) and inhaled corticosteroids (ICS) result in improvements in symptoms, reduce the frequency and severity of exacerbations, and improve health-related quality of life. This review evaluates the clinical evidence for the potential of LABA/ICS treatment to address the symptoms of COPD and whether combination therapy of this nature adds significant benefit to patients.

What's in this issue?

“…We include two reviews in this issue. The first, by Onno van Schayck and Jim Reid [18], outlines the clinical evidence supporting combination treatment with long-acting beta-2 agonists (LABAs) and inhaled corticosteroids (ICS) for patients with chronic obstructive pulmonary disease (COPD). They highlight the multicomponent nature of COPD, and present the evidence relating to improvements in lung function, symptoms, health status, exacerbations, and mortality, in COPD patients treated with LABA/ICS combination inhalers.…”

Inspiratory capacity and forced expiratory volume in the first second in exacerbation of chronic obstructive pulmonary disease

“…Long‐acting bronchodilators alone or in combination with inhaler steroids are used in patients with COPD. Using inhaled streroids in COPD decreases airway inflammation, increases arterial oxygen pressure and decreases exacerbation rate (8–10). Non‐pharmacologic treatments for COPD include long‐term oxygen therapy, nasal positive pressure ventilation, pulmonary rehabilitation, lung volume reduction surgery and smoking cessation (8).…”