A Guide to COPD Treatments and Clinical Trials

What is it? Conditions Symptoms Treatments Medications Breakthroughs

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What is COPD?

COPD (chronic obstructive pulmonary disease) is a group of lung diseases characterized by progressive damage to the lungs. This makes it more difficult to breathe. It also gets harder for lung tissue to process oxygen. Symptoms worsen over time.

Risk increases with age, but the main cause of COPD is smoking. Smoking is believed responsible for about 90% of all COPD cases. Compounds in smoke harm the airways, making the condition more likely. In rarer cases, COPD can arise due to toxic chemicals in the workplace.

Experts estimate about one in every 100 people has a genetic propensity to develop COPD. You are more likely to experience it if you have this characteristic and a close relative, such as a parent or sibling, with COPD.

What Conditions Are Associated with COPD?

The two conditions that make up COPD are emphysema and chronic bronchitis.

Bronchitis refers to a kind of upper respiratory illness. It damages lung tissue through inflammation of bronchial tubes, which carry air to and from lungs. Bronchitis can be caused by a cold or other infection. However, it becomes severe when it is experienced many times over years (chronic).

Emphysema is damage to walls between air sacs of the lungs. The air sacs lose their shape and it becomes difficult to fill air spaces while breathing. As time goes on, the walls of air sacs can be destroyed. This leads to fewer, larger air sacs, making lungs less efficient.

COPD is diagnosed through a series of tests that may include chest x-rays and spirometry. Spirometry is a test that measures the volume of air you exhale. Blood testing is used to eliminate the possibility of other conditions that produce symptoms similar to COPD.

Nearly 16 million American adults have COPD. However, the disease is under-diagnosed and COPD diagnosis comes as a surprise to many. Patients are at higher risk of complications from many factors, from air pollution to respiratory infections like COVID-19.

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What Are the Symptoms of COPD?

COPD progresses in four phases. Phase one symptoms are relatively mild. In each phase, symptoms become worse. This reflects the difficulty that the lungs have processing oxygen. COPD symptoms include:

  • Frequent coughing or wheezing
  • Excessive phlegm
  • Shortness of breath
  • Difficulty breathing deeply

With later progression of COPD, COPD patients might experience more frequent respiratory infections, swelling of the lower extremities, chest tightness, and wheezing or coughing when performing basic tasks. Oxygen levels in the blood will tend to decrease over time.

COPD Treatments

Smoking cessation can slow COPD progress. This is especially true in early stages of the disease, when lifestyle changes have the greatest impact on prognosis. However, ongoing health care is essential.

Many COPD patients will be prescribed a rescue inhaler. The inhaler includes a class of common COPD drugs called bronchodilators. When inhaled, they open up the lungs’ airways and rapidly improve symptoms. Bronchodilators also help remove mucus from the lungs.

In addition to the primary care doctor, COPD health care may include a pulmonary rehabilitation specialist. This person provides training on specific exercises and lifestyle changes that foster healthy lung function.

Exercise and weight loss alone are not considered COPD treatments. However, aerobic exercise helps the body to process oxygen more effectively, while weight loss can make many body systems more efficient.

Periodic testing during COPD treatments will determine whether a patient may benefit from supplemental oxygen, also known as oxygen therapy. This reduces organ stress by making it easier for the body to access a supply of oxygen. It also helps to maintain the patient’s quality of life.

Diseased lung tissue may be excised from the lungs to lower risks related to progressive lung damage. A lung transplant may be recommended in the most severe cases of chronic obstructive pulmonary disease.

COPD Drugs and COPD Medications

COPD medicine has come a long way in recent years thanks to ongoing clinical studies for COPD. Dozens of COPD clinical studies are carried out in the average year. Although 2020 has seen a slowdown in most clinical trial activity, COPD is an area that is sure to receive continued attention.

The category of COPD drugs is extremely large and is growing bigger all the time. Because there are so many COPD medications, it can take some time and testing before the right one is found for any given patient. Luckily, many COPD medications produce at least some positive results in most patients.

Some of the most common COPD medications include:

  • Bronchodilators
  • Inhaled steroids
  • Combination inhalers (bronchodilators combined with inhaled steroids)
  • Antibiotics (during periods of respiratory infection)

COPD medicine for those with more severe symptoms includes:

Oral steroids

Oral steroids reduce inflammation for people who experience periodic, severe COPD flare-ups. Short-term use for a few days can cause a COPD flare-up to clear up faster than it normally would.

Phosphodiesterase-4 inhibitors

A COPD medicine approved for the most severe cases, this decreases airway inflammation and allows the airways to relax. Patients should be alert for side effects including weight loss and diarrhea.

Theophylline

Used when other COPD medications are ineffective, theophylline benefits breathing and controls nausea. The medication is relatively inexpensive and side effects can be curbed with careful dose management.

Once a COPD medicine is chosen for a patient, he or she should take it in accordance with the doctor’s instructions. Occasional re-testing is performed to check lung function and monitor for signs that the disease is progressing from one phase to the next. COPD medications and dosages may change over time.

New COPD Breakthroughs

Several new COPD treatments are in the testing phases or will soon be available:

Targeted Lung Denervation

Radiotherapy is used to interrupt nerve transmissions that affect bronchial tubes. This creates permanent opening of the airways and reduction in both mucus production and inflammation in the treated region.

Robotic Lung Volume Reduction Surgery

Lung volume reduction surgery is now being performed using specialized robotic devices. These robots precisely target and remove damaged areas of the lungs, reducing scarring and improving lung function.

Bronchoscopic Thermal Vapor Ablation

BTVA combats the effects of lung sac damage caused by emphysema. Heated water vapor is used to reduce lung volume in precisely targeted areas. COPD clinical trials of this new treatment are ongoing.

Endobronchial Coils, Endobronchial Valves, and Intrabronchial Valves

This COPD treatment focuses on placing coils or valves into the lungs for severe emphysema. Research has shown promising results in the form of improved lung function, exercise capacity, and quality of life.

Bronchial Rheoplasty

This minimally invasive COPD surgery destroys mucus-producing cells in the lungs. Short electrical bursts are applied to the inner walls of bronchial tubes. This makes mucus-producing cells break open and die.

While a true COPD cure is not yet in sight, there is hope. A COPD cure would need to not only stop the progression of COPD, but help the body repair existing bronchial damage. Medical researchers have made great progress in the fight to stop COPD damage, but it may be many years before a COPD cure is available. Until then, COPD patients and their families can advance the fight by participating in COPD clinical trials

COPD Clinical Trials Currently Recruiting

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