Navigation Links
Treating COPD Early Improves Outcomes
Date:8/27/2009

New drug might slow the destructive lung condition, studies show

THURSDAY, Aug. 27 (HealthDay News) -- Although there is no cure for chronic obstructive pulmonary disease (COPD), starting treatment early may slow progression of the illness and add years to the lives of sufferers, new research finds.

COPD is a progressive, destructive disease of the lungs that is usually brought on by years of smoking. Symptoms include restricted breathing, secretion of mucus, oxidative stress and airway inflammation. It is estimated that as many as 24 million Americans have COPD, and the number is rising.

Three reports published in the Aug. 29 issue of The Lancet, a special issue devoted to COPD, offer new insight into treatments, including a new anti-inflammatory drug that shows promise.

In the first report, patients who began treatment early with the inhaled drug tiotropium (Spiriva) had better outcomes compared with untreated patients.

"If you treat moderate disease with these anticholinergic drugs, you get clear improvements in lung function, health-related quality of life, exacerbations and even, maybe, in mortality, but that was not statistically significant, but there was a trend," said lead researcher Dr. Marc Decramer, a professor in the department of pathophysiology at University Hospital of the University of Leuven in Belgium.

In addition, "you seem to reduce the rate at which the disease progresses," he noted.

For the study, Decramer's group followed 2,376 patients with early COPD who took part in a study for four years. These patients were randomly assigned to receive Spiriva or a placebo.

The researchers found that the rate of decline in lung function was 12 percent lower among patients receiving Spiriva than for patients receiving the placebo.

In addition, patients taking Spiriva were healthier. Flare-ups of the disease were cut 18 percent, and hospitalizations resulting from flare-ups were reduced 26 percent, compared with patients taking the placebo, the researchers found.

For the best outcomes, Decramer said, COPD needs to be diagnosed in its early stages, and aggressive therapy should begin as soon as possible.

"We need to treat these patients earlier than we presently do," Decramer said.

Dr. Norman Edelman, chief medical officer of the American Lung Association, agreed that the findings highlight the need to start COPD treatment when the illness is still mild.

"The major new finding is the efficacy of an anticholinergic in patients with relatively mild COPD in improving lung function and quality of life," Edelman said. "The effects were small but seem real. This is of significance because it points out the usefulness of case finding and treatment of relatively early COPD cases, a somewhat neglected area in clinical practice."

Two other reports in the same edition of the journal show the benefit of the new drug roflumilast (Daxas) in treating COPD.

Daxas, an anti-inflammatory, is still going through the drug approval process in the United States and elsewhere.

In one study, Dr. Leonardo Fabbri from the University of Modena in Italy and colleagues randomly assigned 3,091 patients with severe COPD to Daxas or a placebo. Over a year, patients taking Daxas experienced improved lung function and had 17 percent fewer flare-ups than patients taking a placebo.

"These results suggest that different subsets of patients exist within the broad range of COPD, and that targeted specific therapies could improve disease management," the researchers concluded.

In a second report, a research team led by Dr. Klaus F. Rabe, of Leiden University Medical Center in the Netherlands, tested the benefit of Daxas when added to standard COPD treatment with long-acting bronchodilators or anticholinergics.

In this trial, 1,677 patients with moderate-to-severe COPD were randomly assigned to Daxas or a placebo for 24 weeks. Patients were also receiving the bronchodilator salmeterol (Serevent) or the anticholinergic Spiriva.

The researchers found that adding Daxas to treatment with Serevent or Spiriva improved lung function over either drug alone. In addition, Daxas improved respiratory symptoms.

In both studies, Daxas was associated with more adverse side effects, including nausea, diarrhea and weight loss, researchers note.

"Roflumilast improves lung function in patients with moderate-to-severe COPD who are already being treated with long-acting bronchodilators [beta-2 agonists or anticholinergic drugs], although with expected class-specific adverse events. Roflumilast could become an important, concomitant treatment for these patients," Rabe's team wrote.

"These effects are clinically important, but not terribly striking," said Dr. Paul O'Byrne, a professor of medicine at McMaster University Medical Center in Ontario, Canada, and author of an accompanying journal editorial.

For now, there is still no definitive treatment for COPD or treatment that stops the progression in the decrease in lung function.

One problem with these studies is that they don't compare Daxas with inhaled corticosteroids, which are also anti-inflammatories, OByrne said. "We don't know what advantage roflumilast has in patients already taking inhaled corticosteroids," he said.

Dr. Neil Schachter, a professor of pulmonary medicine at Mount Sinai Medical Center in New York City, noted that with only three types of drugs available to treat COPD, something new would be beneficial.

"It's good to have new compounds introduced for the treatment of COPD ... because some patients won't respond to the three [types of] drugs now available," Schachter said.

More information

For more information on COPD, visit the U.S. National Heart, Lung and Blood Institute.



SOURCES: Marc Decramer, M.D., Ph.D., professor, department of pathophysiology, University Hospital, University of Leuven, Belgium; Paul O'Byrne, M.B., professor, medicine, McMaster University Medical Center, Ontario, Canada; Neil Schachter, M.D., professor, pulmonary medicine, Mount Sinai Medical Center, New York City; Norman Edelman, M.D., chief medical officer, American Lung Association; Aug. 29, 2009, The Lancet


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. HPV vaccine does not appear to be effective for treating pre-existing HPV infection
2. Is 4 agents decoction (Si Wu Tang) efficacious in treating primary dysmenorrhea?
3. Treating diabetes during pregnancy can break link to childhood obesity
4. Jefferson specialists studying innovative surgery for effectively treating sleep apnea
5. Treating Diabetes During Pregnancy Could Lead to Thinner Kids
6. Family-based treatment more effective than supportive psychotherapy in treating bulimia
7. Treating depression may improve recovery of heart rate variability following coronary syndromes
8. Antidepressant shows early promise in treating agitation and psychotic symptoms of dementia
9. Hospitals Improve Survival Rates While Treating Sicker Patients Thomson Healthcare Study Shows
10. Stem cells show promise for treating Huntingtons disease
11. Treating obstructive sleep apnea, preventing heart attacks and strokes
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Treating COPD Early Improves Outcomes
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture animations, ... Christina Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package transforms ... Final Cut Pro X . Simply select a ProHand generator and drag it above ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, ... at Work award to iHire in recognition of their exemplary accomplishments in worksite health ... annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. ...
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle Cell ... pain and the benefits of holistic treatments, Serenity Recovery Center of Marne, ... Cell Disease. , Sickle Cell Disease (SCD) is a disorder of the red blood ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with ... Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Clinical Decision Making in Emergency Medicine conference in Ponte Vedra Beach, FL. The ... published in Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Calif. , June 24, 2016  Global ... a biopharmaceutical company developing novel therapeutics for the ... needs, today announced the closing of its previously ... common stock, at the public offering price of ... the offering were offered by GBT. GBT estimates ...
(Date:6/24/2016)... , June 24, 2016 ... Markets has announced the addition of the " ... offering. This ... and provides an updated review, including its applications in ... the total market, which includes three main industries: pharmaceutical ...
(Date:6/24/2016)... 2016 The Academy of Managed Care Pharmacy ... that would allow biopharmaceutical companies to more easily share ... formulary and coverage decisions, a move that addresses the ... The recommendations address restrictions in the sharing ... drug label, a prohibition that hinders decision makers from ...
Breaking Medicine Technology: