Future of chronic obstructive pulmonary disease management

Abstract

Bronchodilators play a pivotal role in the management of symptomatic chronic obstructive pulmonary disease. Inhaled short-acting bronchodilators are used for all stages of chronic obstructive pulmonary disease, primarily for the immediate relief of symptoms; inhaled long-acting bronchodilators are recommended for maintenance therapy in patients with moderate-to-very severe disease and those with daily symptoms. When symptoms are not adequately controlled by a single bronchodilator, combining bronchodilators of different classes may prove effective. Several long-acting β₂-agonists and long-acting muscarinic antagonists with 24-h duration of action and inhalers combining different classes of long-acting, once-daily bronchodilators are in development. The place of these agents in the treatment algorithm will be determined by their efficacy and safety profiles and their long-term impact on relevant clinical outcomes.

Keywords::

• bronchodilators
• COPD
• glycopyrronium bromide
• indacaterol
• LABA
• LAMA
• lung function
• NVA237
• QVA149
• tiotropium

Acknowledgements

The content of this review is based on a presentation made as part of a Novartis-sponsored satellite symposium presented at the European Respiratory Society Annual Congress 2011.

Financial & competing interests disclosure

A D’Urzo has received research, consulting and lecturing fees from GlaxoSmithKline, Sepracor, Schering Plough, Altana, Methapharma, AstraZeneca, ONO Pharma, Merck Canada, Forest Laboratories, Novartis Canada/USA, Boehringer Ingelheim (Canada) Ltd, Pfizer Canada, SkyePharma and KOS Pharmaceuticals. C Vogelmeier has received fees for presentations at symposia sponsored by AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Janssen-Cilag, Novartis, Nycomed, Pfizer and Talecris, and for consulting from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Janssen-Cilag, Novartis, Nycomed and Talecris. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

The authors were assisted in the preparation of the manuscript by Shilpa Mudgal from CircleScience (Tytherington, UK) and Mark J Fedele from Novartis. This writing assistance was funded by Novartis Pharma AG.