From the Guidelines
COPD (Chronic Obstructive Pulmonary Disease) is a progressive lung disease characterized by persistent airflow limitation that is not fully reversible, with the two main examples being chronic bronchitis and emphysema, as defined by the most recent guidelines 1.
Definition and Examples of COPD
The definition of COPD has been refined over the years, with the most recent guidelines emphasizing the importance of persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases 1.
- Chronic bronchitis involves inflammation and narrowing of the bronchial tubes with excessive mucus production.
- Emphysema causes destruction of the alveoli (air sacs) in the lungs. These conditions often coexist in patients with COPD, leading to a complex clinical presentation.
Risk Factors and Pathogenesis
The disease typically develops due to long-term exposure to irritants that damage the lungs, with cigarette smoking being the primary cause 1.
- Other risk factors include occupational dust and chemical exposure, air pollution, and genetic factors like alpha-1 antitrypsin deficiency. The pathogenesis of COPD involves oxidative stress, protease-antiprotease imbalance, inflammatory mediators, and pathophysiologic changes, leading to persistent airflow limitation 1.
Symptoms and Progression
COPD leads to symptoms such as shortness of breath, chronic cough, wheezing, chest tightness, and frequent respiratory infections 1.
- The disease progresses over time, causing increasing breathing difficulty and potentially leading to respiratory failure, pulmonary hypertension, and heart problems if left untreated. While COPD cannot be cured, proper management with medications, pulmonary rehabilitation, and lifestyle changes can help control symptoms and slow disease progression 1.
Management and Treatment
The 2023 Canadian Thoracic Society guideline on pharmacotherapy in patients with stable COPD provides an update on the optimal approach to the pharmacological treatment of individuals with COPD, aiming to alleviate symptoms, improve health status, and prevent exacerbations 1.
- A comprehensive approach to COPD management, including confirming diagnosis with spirometry, evaluating symptom burden and health status, and implementing pharmacological and non-pharmacological treatments, is recommended.
- Relevant and evidence-based non-pharmacologic interventions, such as smoking cessation counseling, vaccinations, self-management education, and pulmonary rehabilitation, are vital for effective comprehensive management of COPD.
From the FDA Drug Label
- 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.
COPD stands for Chronic Obstructive Pulmonary Disease. It is a condition that makes it hard to breathe and can include conditions such as:
- Chronic bronchitis
- Emphysema 2
From the Research
Definition of COPD
- Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases 3.
- COPD is defined as a global public health problem with increasing impact, and its treatment guidelines recommend the use of inhaled bronchodilators to decrease symptoms, improve lung function and quality of life, and prevent exacerbations 4.
Examples of COPD Treatment
- Fluticasone propionate/salmeterol is a combination inhaled steroid and long-acting bronchodilator that is delivered by a dry-powder inhaler and is used in the treatment of COPD 4.
- Formoterol is a highly selective and potent β2-agonist that relaxes airway smooth muscle to significantly improve lung function, and is used as a monotherapy or in combination with other agents in the treatment of moderate to severe COPD 5, 6.
- Inhaler therapy is the backbone of COPD treatment and should be complemented by a multifaceted management strategy that includes counseling and pharmacotherapy for smoking cessation, pulmonary rehabilitation, treatment of comorbidities, administration of influenza and pneumococcal immunizations, and prescription of long-term oxygen therapy in hypoxemic patients 7.
COPD Characteristics
- COPD is characterized by persistent respiratory symptoms and progressive airflow obstruction, with tobacco smoking being the leading cause but not the only one 7.
- A postbronchodilator FEV1-FVC ratio less than 0.70 is required for a diagnosis of COPD 7.
- Exacerbations and comorbidities contribute to the overall severity in individual patients, and COPD is increasingly divided into subgroups or phenotypes based on specific features and association with prognosis or response to therapy 3.