What is the recommended treatment for Chronic Obstructive Pulmonary Disease (COPD)?

From the Guidelines

The recommended treatment for COPD involves a multi-faceted approach, with LABD maintenance therapy in all symptomatic patients, and single inhaler dual therapy LABD in those with moderate to severe dyspnea and/or poor health status, as recommended by the 2023 Canadian Thoracic Society guideline 1.

Key Components of COPD Treatment

• Smoking cessation is crucial as it slows disease progression
• Bronchodilators, including long-acting beta-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs), form the cornerstone of pharmacological treatment
• Inhaled corticosteroids (ICS) may be added for patients with frequent exacerbations
• Pulmonary rehabilitation programs, combining exercise training, education, and behavioral interventions, are essential for improving quality of life
• Oxygen therapy is recommended for patients with severe hypoxemia
• Vaccinations against influenza and pneumococcal disease are important preventive measures

Pharmacological Treatment

• LABD maintenance therapy is recommended for all symptomatic patients with COPD confirmed by spirometry 1
• Single inhaler dual therapy LABD is recommended for patients with moderate to severe dyspnea and/or poor health status
• Single-inhaler triple therapy may be considered for patients with persistent moderate to severe dyspnea and/or poor health status despite treatment with single inhaler dual therapy
• SITT (Triple therapy: ICS/LABA/LAMA) reduces mortality in individuals with moderate-severe disease and a high risk of AECOPD, and is suggested for all patients at high risk of AECOPD 1

Non-Pharmacological Interventions

• Pulmonary rehabilitation programs are essential for improving quality of life and reducing symptoms
• Oxygen therapy is recommended for patients with severe hypoxemia
• Vaccinations against influenza and pneumococcal disease are important preventive measures
• Smoking cessation is crucial as it slows disease progression

Acute Exacerbations

• Treatment includes increased bronchodilator use, oral corticosteroids, and antibiotics if bacterial infection is suspected
• These treatments work by reducing airway inflammation, improving airflow, strengthening respiratory muscles, and preventing complications, ultimately aiming to reduce symptoms, improve quality of life, and slow disease progression.

From the FDA Drug Label

1. 2 Maintenance Treatment of Chronic Obstructive Pulmonary Disease Wixela Inhub® 250/50 is indicated for the twice-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. The recommended dosage for patients with COPD is 1 inhalation of Wixela Inhub® 250/50 twice daily, approximately 12 hours apart.

The recommended treatment for Chronic Obstructive Pulmonary Disease (COPD) is Wixela Inhub® 250/50, which should be administered as 1 inhalation twice daily, approximately 12 hours apart 2.

• The treatment is indicated for the maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema.
• Wixela Inhub® 250/50 is also indicated to reduce exacerbations of COPD in patients with a history of exacerbations.
• If shortness of breath occurs in the period between doses, an inhaled, short-acting beta2-agonist should be taken for immediate relief 2.

From the Research

Treatment Options for COPD

The recommended treatment for Chronic Obstructive Pulmonary Disease (COPD) includes:

• Inhaled bronchodilators, such as long-acting muscarinic receptor antagonists (LAMA) and long-acting β2-adrenoreceptor agonists (LABA) 3
• LAMA/LABA fixed dose combinations (FDCs) for convenience and additive or synergistic bronchodilation 3, 4
• Inhaled dual-pharmacology compounds, combining muscarinic antagonism and β2-agonism (MABA) in a single molecule 3, 5

Bronchodilators for COPD

Bronchodilators play a pivotal role in the treatment of symptomatic patients with COPD, with:

• Inhaled short-acting bronchodilators recommended for rescue of symptoms in patients with mild disease 6
• Inhaled long-acting bronchodilators recommended as first-line agents for maintenance therapy in patients with moderate and severe disease and those with daily symptoms 6, 7
• Long-acting bronchodilators improving symptoms, exercise tolerance, and health status, and reducing exacerbations in patients with COPD 6, 7

Choosing the Optimal Bronchodilator

When choosing a bronchodilator, considerations include:

• Efficacy gradient among different LABA/LAMA FDCs 4
• Inhaler devices and potential biomarkers 4
• Combination of a long-acting beta2-adrenoceptor agonist and a long-acting anticholinergic agent for patients with severe COPD 6