From the Guidelines
Pulmonary rehabilitation is the only therapy shown to improve the natural history of Chronic Obstructive Pulmonary Disease (COPD). This comprehensive intervention, which includes exercise training, education, and behavior change, has been demonstrated to reduce dyspnea, increase exercise capacity, and improve quality of life in individuals with COPD 1. The benefits of pulmonary rehabilitation are considerable, with a significant reduction in hospitalizations compared to conventional care, particularly when initiated immediately after a COPD hospitalization 1.
Key aspects of pulmonary rehabilitation include:
- Exercise training to improve physical condition and reduce symptoms
- Education to promote health-enhancing behaviors and self-management
- Behavior change to encourage long-term adherence to healthy habits The American Thoracic Society (ATS) and the European Respiratory Society (ERS) have adopted a new definition of pulmonary rehabilitation, emphasizing its comprehensive and patient-tailored approach 1. While other therapies, such as bronchodilators and inhaled corticosteroids, can help manage symptoms and reduce exacerbations, pulmonary rehabilitation is the most effective therapeutic strategy to improve shortness of breath, health-related quality of life, and exercise tolerance in patients with COPD 1.
From the FDA Drug Label
The primary efficacy endpoint was all-cause mortality Survival with fluticasone propionate and salmeterol inhalation powder 500 mcg/50 mcg was not significantly improved compared with placebo or the individual components (all-cause mortality rate 12.6% fluticasone propionate and salmeterol inhalation powder versus 15.2% placebo). The answer to the question of what is the only therapy shown to improve the natural history of COPD is not directly stated in the provided drug label. However, based on the information provided, lung function and symptom scores improved with certain treatments, but there is no clear indication that any therapy improved the natural history of COPD in terms of survival or mortality.
- The label does mention that fluticasone propionate and salmeterol inhalation powder 500 mcg/50 mcg did not significantly improve survival compared to placebo or individual components.
- No conclusion can be drawn regarding the improvement of the natural history of COPD based on the provided information 2.
From the Research
Therapy Improving Natural History of COPD
- Pulmonary rehabilitation is the only therapy shown to improve the natural history of Chronic Obstructive Pulmonary Disease (COPD) 3, 4, 5.
Key Components of Pulmonary Rehabilitation
- Exercise training, including aerobic training, upper-limb exercises, and inspiratory muscle training 3, 6.
- Education and self-management strategies 5.
Benefits of Pulmonary Rehabilitation
- Improves exercise tolerance and quality of life 3, 4, 5.
- Reduces cardiovascular risk factors and dyspnea 3, 4.
- Decreases hospital readmissions and improves 1-year survival 5.