Mono- and Combination Therapy of Long-acting Bronchodilators and Inhaled Corticosteroids in Advanced COPD

Jill A. Ohar; James F. Donohue

Disclosures

Semin Respir Crit Care Med. 2010;31(3):321-333. 

In This Article

Bronchodilators in COPD: Conclusions

The use of bronchodilators is central in the symptomatic management of COPD, and currently available agents have been shown to have significant effects on the long-term outcome and management of COPD ( Table 3 , Table 4 , and Table5 ). The use of the inhaled route is currently preferred to minimize systemic effects. Quick-acting and short-acting agents are best used for rescue of symptoms, whereas long-acting agents are best used for maintenance therapy. The choice of agents may be based primarily on individual response, cost, side effect profile, and availability Table 4 .

Several new bronchodilators are currently being studied in ongoing clinical trials that may improve the future treatment of COPD. The current opinion is that it will be advantageous to develop inhalers containing combinations of several classes of long-acting bronchodilator drugs in an attempt to simplify treatment regimes as much as possible. Specific future research should examine the long-term efficacy and long-term safety of the different combination of bronchodilators ± inhaled corticosteroids, as well as their effects on the natural history of COPD when used early in the disease progression. Furthermore, future studies should also identify more sensitive methods to assess response to bronchodilators and identify through responder analyses specific groups based on gender, age, race, or pharmacogenetic makeup.

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