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Inhalers Slow COPD Lung Function Loss

Drug Therapy Slows Breathing Decline in Chronic Lung Disease
By
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 15, 2008 -- For the first time, a major study shows that currently available inhaled medications can slow the deadly loss of lung function in COPD -- chronic obstructive pulmonary disease.

As we age, our lungs work less and less well. But this process greatly accelerates in people with COPD, for whom breathing becomes progressively more difficult.

In the U.S., some 85% of people with COPD are smokers. Until now, quitting smoking has been the only proven way to slow COPD-related loss of lung function.

Patients still need to quit smoking. But now it's clear that an aggressive treatment already being used by many doctors helps COPD patients breathe better.

The treatment combines a long-acting version of the rescue inhalers used by asthma patients -- a long-acting beta-agonist drug -- with a corticosteroid inhaler.

In the study, patients who got the combination treatment did best. But those treated either with the beta-agonist Serevent or the corticosteroid Flovent did much better over three years of treatment than did patients who got an inactive placebo inhaler.

"We have shown for the first time that pharmacologic therapy slows the decline in lung function in patients with COPD," conclude study leader Bartolome R. Celli, MD, of Tufts University, and colleagues.

The "important" findings will change COPD treatment guidelines, predicts John Heffner, MD, past president of the American Thoracic Society and chair of medicine at Oregon's Providence Portland Medical Center.

"One of the major problems with COPD is difficulty getting air out of the lungs," Heffner tells WebMD. "Over time, patients have progressive deterioration faster than a healthy aging population. And this study indicates the deterioration can best be lowered with drug therapy."

Long-acting beta-agonists include Serevent, Foradil, and Oxis. There are many inhaled corticosteroids; the one used in the study was fluticasone, marketed as Flovent and Flixotide. Combination products that include a long-acting beta-agonist and an inhaled steroid include Advair, Seretide, and Symbicort.

The study, sponsored by GlaxoSmithKline, used the Glaxo products Advair, Flovent, and Serevent.

Celli and colleagues report the findings in the American Journal of Respiratory and Critical Care Medicine.

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