A Guide to Chronic Obstructive Lung Disease and Clinical Trials

Chronic obstructive lung disease (COPD) is a lung condition that makes breathing, one of the most basic bodily functions, difficult. This disease can make everyday living harder, but not impossible. Currently, there are a variety of therapies, programs, and medicines available to patients to help alleviate COPD symptoms. Clinical research and trials that patients can easily participate in are also striving to discover new and improved ways to treat COPD. This guide is intended to help educate those living with COPD about the condition itself and about the resources available to help treat it.

ABOUT COPD

Chronic obstructive lung disease (COPD) is a lung condition that makes breathing difficult and that is currently incurable. There are two types of COPD, one caused by chronic bronchitis and the other caused by emphysema.

  • Chronic bronchitis – a condition where the bronchial tubes of the lungs become inflamed and produce extra mucus which impedes one’s airflow.
  • Emphysema – a disease where the lung’s air sacs become inflamed and ultimately damaged, making breathing difficult.

COPD can cause many symptoms which may interfere with the patient’s everyday life. The most common symptoms reported include, but are not limited to:

  • Dyspnea, or breathlessness
  • Coughing
  • Wheezing
  • Sputum, or mucus, production

The severity of patients’ symptoms may vary. Some may not even notice their symptoms, unless doing strenuous physical activities, while others may become out of breath from just dressing and undressing. It should be noted that these symptoms may be caused by another condition or disease, such as asthma, a respiratory infection, or lung cancer. One must contact his or her health care provider to receive a proper diagnosis.

Some diseases also naturally accompany COPD. These illnesses include, but are not limited to:

  • Cardiovascular disease
  • Skeletal muscle dysfunction
  • Metabolic syndrome
  • Osteoporosis
  • Depression
  • Anxiety
  • Lung cancer

It is important for health care providers to actively search for and attend to these accompanying illnesses so that symptoms do not become worse.

COPD patients commonly experience flare ups, which are also known as exacerbations.

  • Flare ups – Periods of time where symptoms of a certain disease become worse in a patient.

Flare-ups are usually brought about when the patient has a cold, a flu, or an infection. They can be very dangerous because they could damage the lungs further. It is important to talk to a health care provider so that steps to prevent flare ups from happening can be taken.

CAUSES OF COPD

COPD is usually caused by something noxious that irritates the lungs over an extended period of time. Although, there are other factors that may cause or increase the chances of acquiring this disease. These irritants and factors are discussed below.

Cigarette Smoking:

The worldwide culprit for most people is cigarette smoking. In fact, 90% of people with COPD in the United States acquired the condition from smoking! This is why it is extremely important for people to quit smoking, especially those with so that they do not damage their lungs any further. Smoking tobacco from other devices such as cigars, pipes, and bongs are also known to cause COPD, as well as smoking marijuana.

Pollution:

Pollution is also a major irritant that can also cause COPD. This includes both indoor and outdoor pollutants. With the use of fossil fuels on the rise, more and more areas of the world are experiencing higher amounts of pollution in the air. Living in an area with high pollution rates may increase the risk of COPD. One of the most polluted areas in the United States is Los Angeles. Indoor pollution such as smoke from smoking indoors, aerosol sprays, and fumes from unclean furnaces or poorly ventilated cooking areas also can irritate the lungs.

Genetics:

Genetics may put people at a higher risk of COPD. Some of these genetic factors include:

  • Severe hereditary deficiency of alpha-1 antitrypsin (AATD)
  • Lung development during childhood, like recurrent respiratory infections or low birth weight
  • Female gender

DIAGNOSIS

If a patient thinks he or she is think experiencing symptoms of COPD, it is advised to a healthcare provider as soon as possible for proper diagnosis. It is common for healthcare providers to take a detailed medical history and give a full physical exam. Other tests are also required. These tests include:

  • Spirometry – The most efficient test on a person’s airflow which will recognize any breathing impediment. Results of a post-bronchodilator FEV1/FEV<0.70 would mean there is a breathing impediment. This test could recognize other conditions, like asthma, so it is important to combine the test results with the patient’s symptoms for proper diagnosis.
  • Oxygen in the blood – The normal amount of oxygen in the blood should be between 75 and 100 mm Hg. Anything under 75 would indicate a problem with the lungs, like COPD.
  • Chest x-ray or cat scan – These will allow the doctor to view any abnormalities of the lungs.
  • COPD Assessment Test (CAT) – This test is a list of questions that can also help a physician diagnose a patient with COPD. The assessment test consists of symptoms the patient may be experiencing and a number scale to rank the severity of these symptoms. For example, “I never cough” compared to “I cough all the time.”

TREATMENT

Many medicines, methods, and programs are readily available to people living with COPD to help reduce their symptoms. Clinical research and trials are also helping to improve these treatments. The treatments are all listed below.

Medicine:

Medicine is prescribed by a health care provider. Sometimes patients will be prescribed a combination of medicines to assess their individual needs. There are long acting and fast acting versions of these drugs.

  • Long acting medicine – These medications are taken on a regular basis and help to continually reduce symptoms.
  • Fast acting medicine – These medications are taken on a special occasion, usually when symptoms worsen and there is a flare up, to quickly reduce symptoms back to a normal level.

The medicines are either inhaled or ingested by pill. Common medications are listed as follows:

  • Bronchodilators
  • Beta-agonists (inhaled)
  • Anticholinergics (inhaled)
  • Phosphodiesterase-4 inhibitors (pill)
  • Theophylline (pill)
  • Steroids (inhaled or pill)

The medications that are inhaled can be taken by the following:

  • Metered dose inhalers – This device distributes a specific amount of medication by spraying vaporized medication when one inhales. It is the most common way of taking medication for COPD patients.
  • Dry powder inhalers – This device works the same as a metered dose inhaler but the medication is delivered through dry powder.
  • Nebulizers – This device delivers the medication via mist and requires a face mask so that it may be breathed into the lungs for a certain amount of time.

Oxygen Therapy:

Supplemental oxygen may be necessary if the blood is not receiving enough oxygen. The amount of oxygen needed varies from patient to patient, depending on the severity of their COPD. Oxygen treatment can have many benefits such as:

  • Sleep improvement
  • Mental function improvement
  • Exercise improvement

Oxygen can be administered through several devices which include the following:

  • Oxygen tanks
  • Liquid oxygen systems
  • Concentrators

These devices all deliver oxygen to the patient and are now available in portable forms so that users can live their everyday lives with no hassle.

Lifestyle Changes:

Lifestyle changes can play a major role in alleviating the symptoms of COPD and in the overall health for patients. It is essential for patients to quit smoking and to exercise as these changes will have a major impact on their wellness. Both of these changes can be very difficult to achieve, so there are tips provided below to assist those with COPD.

  • How to quit smoking:
    • Talk to a healthcare provider that can give medical advice on how and why to quit smoking.
    • Try nicotine replacement therapy like nicotine gum and patches that will reduce the urge.
    • Try prescription pills that can stop cravings and reduce withdrawals.
    • Get support from loved ones and support groups.
    • Exercise!
  • How to start exercising:
    • Talk to a healthcare provider that can give medical advice on how and why to start exercising.
    • Set goals.
    • Exercise with groups of people or friends to help with motivation and accountability.
    • Try a pulmonary rehabilitation program.
    • Maintain a schedule.

Positive Attitude:

A positive attitude can go a long way in the health of those with COPD. It is easy to feel extremely weighed down by COPD. Some common comorbidities that accompany this disease are depression and anxiety. A healthy mind is just as important as a healthy body. It is important to keep family members and friends close to help support those with COPD. It is also recommended to speak to a counselor who can guide those finding it hard to stay positive. It is important for patients to remember that they are not alone, that they have many resources, and that they are not defined by this disease! Depression or anxiety must be assessed and proper treatment should be administered to avoid flare ups. For patients who think they may be suffering from anxiety or depression, they should speak to a health care provider as soon as possible.

Clinical Trials:

Clinical trials are how pharmaceutical companies test their new drugs. The drugs are usually on their later stages of development and are aimed to potentially cure COPD or improve the medications, treatments, and therapies that are already on the market. By participating in clinical trials, patients are given the chance to try a potential cure and to play a large role in the advancement of COPD research. After all, most of the current treatments are available and accessible because of their success in previous clinical trials!

The hardest part about these studies is finding enough patients to participate, so researchers are constantly looking for more participants! Both patients and researchers gain from these clinical trials. All patients have to do is meet the eligibility requirements for the different trials, like age, gender, stage of disease, and previous treatments. The benefits of clinical trials include the following:

  • Participants are given advanced treatment and therapy that isn’t even available to other patients.
  • Participants usually receive better health care than others.
  • Participants have the chance to play an important role in finding treatments that could later help COPD patients all over the world.
  • Participants are sometimes paid for participating in studies.
  • Participants are monitored closely during and after the study to ensure their safety.

Some current clinical trials are already on their way to making life changing discoveries. Some of these studies include the following:

  • Prevention of Acute Worsening of COPD – The goal of this study is to test a new drug called metoprolol on patients and to measure its effect on exacerbations. It will be studied by measuring the time until the patient acquires the first exacerbation after using the drug, and the severity of such exacerbation.
  • Spiration Valve for Emphysema to Improve Lung Function – the goal of this study is to improve the lung function for people living with emphysema by testing a new treatment called the Spiration Valve. The spiration valve is a small device placed in the airways of the lungs for the purpose of redirecting airflow to healthier parts of the lungs.

There are much more studies available to patients to participate in and benefit from all over the world. New and more advanced research on COPD is also being discovered every day because of these studies! To make a difference, patients only have to get connected to these studies and participate!

CONCLUSION

Chronic obstructive pulmonary disease (COPD) can seem to make living a normal life difficult at times; however, with the right treatments and attitude, living with COPD is not impossible. In fact, many patients are surprised at what they can accomplish after receiving the right treatments and making healthy changes in their lifestyle! Furthermore, clinical trials and research are actively studying even better therapies and potential cures. The more patients participate in these studies, the faster these potential therapies and cures can become available to and help all COPD patients!