From the Guidelines
Chronic Obstructive Pulmonary Disease (COPD) typically presents with symptoms of progressive dyspnea, cough, and sputum production, and is managed with a combination of pharmacological and non-pharmacological interventions 1.
Presentation
The presentation of COPD can vary, but common symptoms include:
- Dyspnea: progressive shortness of breath
- Cough: chronic cough, often with sputum production
- Sputum production: increased sputum production, which can be clear, yellow, or green
- Wheezing: wheezing or whistling sounds while breathing
- Chest tightness: feeling of tightness or heaviness in the chest
Management
Initial treatment often involves the use of:
- Long-acting bronchodilators: such as tiotropium (18mcg once daily) or salmeterol (50mcg twice daily) 1
- Short-acting bronchodilators: like albuterol (90-180mcg as needed) 1 For patients with a history of exacerbations, inhaled corticosteroids, such as fluticasone (250-500mcg twice daily), may be added to the treatment regimen, and pulmonary rehabilitation programs are also recommended to improve symptoms and quality of life 1.
Non-Pharmacological Interventions
Non-pharmacological interventions, such as:
- Smoking cessation: quitting smoking to slow disease progression
- Vaccinations: receiving flu and pneumococcal vaccinations to prevent infections
- Pulmonary rehabilitation: participating in a rehabilitation program to improve lung function and overall health
- Self-management education: learning to manage symptoms and recognize exacerbations are also essential in the management of COPD 1.
Prevention of Exacerbations
Prevention of exacerbations is a key goal in the management of COPD, and can be achieved through:
- Pharmacological interventions: such as long-acting bronchodilators and inhaled corticosteroids
- Non-pharmacological interventions: such as smoking cessation, vaccinations, and pulmonary rehabilitation
- Early recognition and treatment of exacerbations: recognizing and treating exacerbations promptly to prevent hospitalization and improve outcomes 1.
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. Wixela Inhub® 250/50 is also indicated to reduce exacerbations of COPD in patients with a history of exacerbations Wixela Inhub® 250/50 twice daily is the only approved dosage for the treatment of COPD because an efficacy advantage of the higher strength Wixela Inhub® 500/50 over Wixela Inhub® 250/50 has not been demonstrated.
The presentation of Chronic Obstructive Pulmonary Disease (COPD) includes symptoms such as airflow obstruction, chronic bronchitis, and/or emphysema. The management of COPD involves the use of medications such as Wixela Inhub® 250/50, which is indicated for the twice-daily maintenance treatment of airflow obstruction in patients with COPD, and to reduce exacerbations of COPD in patients with a history of exacerbations 2. Key points in the management of COPD include:
- Twice-daily maintenance treatment with Wixela Inhub® 250/50
- Reduction of exacerbations in patients with a history of exacerbations
- Use of the only approved dosage of Wixela Inhub® 250/50 twice daily for the treatment of COPD.
From the Research
Presentation of Chronic Obstructive Pulmonary Disease (COPD)
- COPD is characterized by incompletely reversible expiratory airflow limitation, with symptoms such as dyspnea, cough, and sputum production 3
- The disease is often suspected in patients with a significant smoking history, shortness of breath, and sputum production, and is confirmed by spirometry 4
- A forced expiratory volume in the first second of expiration to forced vital capacity (FEV1/FVC) ratio of less than 0.7 after bronchodilator administration confirms the diagnosis 4
Management of COPD
- The goals of COPD treatment include recognizing the impact of both symptoms and exacerbations on patients' lives, and considering optimal patient-focused management 5
- Therapy for patients with stable COPD should include a bronchodilator, either a long-acting beta2-agonist (LABA) or a long-acting muscarinic antagonist (LAMA) 4
- For patients who continue to experience dyspnea with a single bronchodilator, dual therapy with a LABA and LAMA is appropriate, and for patients with continued exacerbations, inhaled corticosteroids can be added to LABA-LAMA therapy 4
- Acute exacerbations are characterized by a worsening of symptoms that requires additional therapy, and are typically treated with short-acting beta2-agonists, systemic glucocorticoids, and antibiotics as needed 6, 4
- Noninvasive mechanical ventilation is preferred for patients with respiratory failure, and supplemental oxygen is recommended for patients with resting hypoxemia 3, 4
- Pulmonary rehabilitation, which includes strength and endurance training and educational, nutritional, and psychosocial support, improves symptoms and exercise tolerance, but is underutilized 3