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Clin Med Insights Circ Respir Pulm Med. 2013 Apr 25;7:17-34. doi: 10.4137/CCRPM.S7211. Print 2013.

Pharmacotherapies for COPD.

Clinical medicine insights. Circulatory, respiratory and pulmonary medicine

Stan Ejiofor, Alice M Turner

Affiliations

  1. Russells Hall Hospital, Dudley, West Midlands, UK.

PMID: 23700381 PMCID: PMC3653890 DOI: 10.4137/CCRPM.S7211

Abstract

This review article summarizes the main treatments for chronic obstructive pulmonary disease, their mechanisms, and the key evidence from trials supporting their use. Drug classes covered were short acting beta agonists (SABA), short acting muscarinic antagonists (SAMA), long acting beta agonists (LABA), long acting antimuscarinics (LAMA), inhaled corticosteroids (ICS), LABA/ICS combinations, specific phosphodiesterase (PDE4) inhibitors, non-specific PDE inhibitors, mucolytics, and oxygen. Non-specific therapies, such as opiates for relief of dyspnoea and therapies for smoking cessation, are also covered briefly. For each class of drug, mechanisms of action are described, key clinical trial results are reported, and available agents compared. Finally, the place of each drug in therapy is compared between current worldwide guidelines.

Keywords: chronic obstructive pulmonary disease; disease management; pharmacotherapies

References

  1. Cochrane Database Syst Rev. 2012 Aug 15;(8):CD001287 - PubMed
  2. Indian J Chest Dis Allied Sci. 2011 Apr-Jun;53(2):81-5 - PubMed
  3. J Clin Pharmacol. 2007 Oct;47(10):1335-41 - PubMed
  4. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD006101 - PubMed
  5. Ann Intern Med. 1980 Sep;93(3):391-8 - PubMed
  6. Thorax. 2010 Jun;65(6):473-9 - PubMed
  7. Eur Respir J. 1997 Apr;10(4):815-21 - PubMed
  8. N Engl J Med. 1975 May 22;292(21):1103-6 - PubMed
  9. Nutrition. 2003 Feb;19(2):120-7 - PubMed
  10. N Engl J Med. 2008 Oct 9;359(15):1543-54 - PubMed
  11. Int J Clin Pharmacol Ther. 2012 Feb;50(2):118-28 - PubMed
  12. Mol Pharmacol. 1994 May;45(5):899-907 - PubMed
  13. Chest. 2002 Apr;121(4):1058-69 - PubMed
  14. Eur Respir J. 2009 May;33(5):1165-85 - PubMed
  15. Am J Respir Crit Care Med. 2009 Nov 15;180(10):948-55 - PubMed
  16. Am J Respir Crit Care Med. 2008 Jan 1;177(1):19-26 - PubMed
  17. BMJ. 2003 Sep 6;327(7414):523-8 - PubMed
  18. Ann Intern Med. 2012 Jan 17;156(2):105-14 - PubMed
  19. Eur Respir J. 2008 Oct;32(4):1047-52 - PubMed
  20. Thorax. 2003 Apr;58(4):289-93 - PubMed
  21. Cochrane Database Syst Rev. 2012 Jul 11;(7):CD002991 - PubMed
  22. Am J Respir Crit Care Med. 2001 Sep 1;164(5):778-84 - PubMed
  23. Proc Am Thorac Soc. 2004;1(3):200-6 - PubMed
  24. J Appl Physiol Respir Environ Exerc Physiol. 1979 Jul;47(1):112-8 - PubMed
  25. Lancet. 2005 Aug 13-19;366(9485):563-71 - PubMed
  26. Thorax. 2003 May;58(5):399-404 - PubMed
  27. Respir Med. 2011 May;105(5):719-26 - PubMed
  28. Clin Pharmacol Ther. 1982 Nov;32(5):566-71 - PubMed
  29. Lancet. 2009 Aug 29;374(9691):695-703 - PubMed
  30. Ann Intern Med. 1987 Feb;106(2):196-204 - PubMed
  31. Cochrane Database Syst Rev. 2002;(4):CD003902 - PubMed
  32. Thorax. 2009 Oct;64(10):910-5 - PubMed
  33. Chest. 1981 Dec;80(6 Suppl):827-30 - PubMed
  34. Drugs Aging. 2004;21(6):405-14 - PubMed
  35. Int J Chron Obstruct Pulmon Dis. 2008;3(4):659-69 - PubMed
  36. Respir Res. 2011 Dec 07;12:156 - PubMed
  37. Thorax. 2002 Nov;57(11):939-44 - PubMed
  38. Br J Clin Pharmacol. 1986 Nov;22(5):587-93 - PubMed
  39. Eur Respir J. 2011 Feb;37(2):273-9 - PubMed
  40. Lancet. 1981 Mar 28;1(8222):681-6 - PubMed
  41. Respir Res. 2011 May 31;12:71 - PubMed
  42. Lancet. 2005 Apr 30-May 6;365(9470):1552-60 - PubMed
  43. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD006103 - PubMed
  44. Chest. 2012 Mar;141(3):745-752 - PubMed
  45. N Engl J Med. 2007 Feb 22;356(8):775-89 - PubMed
  46. Int J Chron Obstruct Pulmon Dis. 2006;1(2):107-14 - PubMed
  47. Thorax. 2002 Oct;57(10):847-52 - PubMed
  48. Eur Respir J. 2008 Sep;32(3):619-28 - PubMed
  49. BMJ. 2012 Nov 09;345:e7390 - PubMed
  50. Proc Am Thorac Soc. 2004;1(4):356-63 - PubMed
  51. Respir Med. 1998 Dec;92(12):1346-51 - PubMed
  52. J Pharmacol Exp Ther. 2012 Nov;343(2):520-8 - PubMed
  53. Int J Clin Pract. 2011 Jul;65(7):764-74 - PubMed
  54. Expert Opin Investig Drugs. 2006 Feb;15(2):107-16 - PubMed
  55. J Clin Pharm Ther. 2012 Apr;37(2):204-11 - PubMed
  56. Respir Res. 2011 Jan 27;12:18 - PubMed
  57. Br J Pharmacol. 1991 Nov;104(3):665-71 - PubMed
  58. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD009157 - PubMed
  59. Am J Respir Crit Care Med. 2008 Aug 15;178(4):332-8 - PubMed
  60. Cochrane Database Syst Rev. 2012 Jul 11;(7):CD009285 - PubMed
  61. Int J Clin Pharmacol Ther. 2011 Aug;49(8):491-9 - PubMed
  62. Respir Res. 2009 Oct 31;10:104 - PubMed
  63. BMJ. 2011 Jun 14;342:d3215 - PubMed
  64. Respir Med. 2001 Oct;95(10):817-21 - PubMed
  65. J Pharmacol Exp Ther. 2009 Aug;330(2):660-8 - PubMed
  66. Arch Bronconeumol. 2012 Sep;48(9):331-7 - PubMed
  67. Int J Chron Obstruct Pulmon Dis. 2006;1(2):99-106 - PubMed
  68. J Pharmacol Exp Ther. 2006 May;317(2):762-70 - PubMed
  69. Lancet. 2003 Feb 8;361(9356):449-56 - PubMed
  70. Eur Respir J. 2003 Dec;22(6):912-9 - PubMed
  71. Thorax. 2009 Aug;64(8):728-35 - PubMed
  72. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD006829 - PubMed
  73. Drug Metab Dispos. 1999 Oct;27(10):1104-16 - PubMed
  74. Eur Respir J. 2003 Jan;21(1):74-81 - PubMed
  75. Mol Pharm. 2010 Feb 1;7(1):187-95 - PubMed
  76. Chest. 1999 Apr;115(4):957-65 - PubMed
  77. Respir Med. 2009 Mar;103(3):325-34 - PubMed
  78. BMJ. 2000 May 13;320(7245):1297-303 - PubMed
  79. Thorax. 2013 Jan;68(1):48-56 - PubMed
  80. J Exp Med. 2006 Jan 23;203(1):7-13 - PubMed
  81. Lancet. 2009 Aug 29;374(9691):685-94 - PubMed
  82. Pulm Pharmacol Ther. 2013 Apr;26(2):256-64 - PubMed
  83. Clin Ther. 2010 Sep;32(10):1798-812 - PubMed
  84. Am J Physiol Lung Cell Mol Physiol. 2004 Jun;286(6):L1122-8 - PubMed
  85. Ther Adv Respir Dis. 2009 Feb;3(1):15-21 - PubMed
  86. Pulm Pharmacol Ther. 2005;18(6):397-404 - PubMed
  87. Am J Respir Crit Care Med. 1998 May;157(5 Pt 1):1418-22 - PubMed
  88. COPD. 2012 Jun;9(3):268-75 - PubMed
  89. Thorax. 2000 Apr;55(4):289-94 - PubMed
  90. Drug Des Devel Ther. 2010 Jul 21;4:147-58 - PubMed
  91. Thorax. 2010 Dec;65(12):1086-91 - PubMed
  92. Eur Respir J. 2013 Jun;41(6):1292-301 - PubMed
  93. J Clin Psychopharmacol. 2013 Feb;33(1):55-62 - PubMed
  94. Chest. 2001 Jun;119(6):1661-70 - PubMed
  95. Br Med J. 1977 Jun 25;1(6077):1645-8 - PubMed
  96. Eur Respir J. 2012 Oct;40(4):830-6 - PubMed
  97. Respir Res. 2011 Apr 26;12:55 - PubMed
  98. Thorax. 2011 Mar;66(3):205-10 - PubMed
  99. JAMA. 2008 Sep 24;300(12):1439-50 - PubMed
  100. Respir Res. 2011 Sep 27;12:127 - PubMed
  101. Am J Respir Crit Care Med. 2001 Apr;163(5):1087-92 - PubMed
  102. Respir Res. 2009 Jun 30;10:59 - PubMed
  103. Drug Metab Dispos. 1993 Nov-Dec;21(6):1022-8 - PubMed
  104. Br J Clin Pharmacol. 1982 Dec;14(6):769-78 - PubMed
  105. Chest. 2008 May;133(5):1079-87 - PubMed
  106. Am J Respir Crit Care Med. 2002 May 15;165(10):1353-8 - PubMed
  107. Int J Chron Obstruct Pulmon Dis. 2008;3(4):763-70 - PubMed
  108. Br J Pharmacol. 1984 Nov;83(3):607-14 - PubMed
  109. J Pharmacol Exp Ther. 2009 Nov;331(2):740-51 - PubMed
  110. Cochrane Database Syst Rev. 2012 Nov 14;11:CD000146 - PubMed
  111. Respiration. 1999;66(5):434-9 - PubMed
  112. N Engl J Med. 2011 Mar 24;364(12):1093-1103 - PubMed
  113. Respir Med. 2006 Jul;100(7):1129-38 - PubMed
  114. Eur Respir J. 2008 Oct;32(4):962-9 - PubMed
  115. Nat Rev Immunol. 2008 Mar;8(3):183-92 - PubMed
  116. J Clin Psychiatry. 2012 May;73(5):654-60 - PubMed
  117. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000031 - PubMed
  118. Int J Chron Obstruct Pulmon Dis. 2012;7:283-9 - PubMed
  119. J Clin Pharmacol. 2004 Feb;44(2):163-72 - PubMed
  120. Eur Respir J. 2012 Nov;40(5):1106-14 - PubMed
  121. Chest. 2006 Jan;129(1):56-66 - PubMed
  122. Am J Respir Crit Care Med. 2007 Jul 15;176(2):154-61 - PubMed
  123. Eur Respir J. 2004 Apr;23(4):629-36 - PubMed
  124. Am J Respir Crit Care Med. 2010 Jul 15;182(2):155-62 - PubMed
  125. COPD. 2011 Oct;8(5):340-5 - PubMed
  126. Eur Respir J. 2011 Oct;38(4):797-803 - PubMed
  127. Br J Pharmacol. 1994 Feb;111(2):641-7 - PubMed
  128. Am J Physiol. 1995 Jan;268(1 Pt 1):L41-6 - PubMed
  129. Chest. 2010 Jul;138(1):179-87 - PubMed
  130. Thorax. 2010 Mar;65(3):215-20 - PubMed
  131. COPD. 2012 Apr;9(2):90-101 - PubMed
  132. J Biol Chem. 1996 Sep 27;271(39):24029-35 - PubMed

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