Managing Stable COPD in 2009: Incorporating Results from Recent Clinical Studies into a Goal-Directed Approach for Clinicians

Abstract

Chronic obstructive pulmonary disease (COPD) is prevalent in primary care practice and an important cause of functional decline, hospitalizations, and death. Recent clinical trials of COPD therapy demonstrate the ability of bronchodilators (especially long-acting β₂-agonists and anticholinergics), either alone or in combination with inhaled corticosteroids, to achieve the goals of managing stable disease. These management goals include: symptom relief, improvement in exercise tolerance and health status, prevention of exacerbations and progression of disease, and reduction in mortality. Recent studies of COPD treatment also provide important safety information to help clinicians address patient concerns about treatment risks. We reviewed recent clinical trials to develop concepts of care for the non-specialist clinician managing patients with stable COPD.

Keywords:

• chronic obstructive pulmonary disease
• bronchodilator agents
• adrenergic beta-agonists
• cholinergic antagonists
• anti-inflammatory agents
• salmeterol
• formoterol
• tiotropium
• pulmonary rehabilitation