COPD Update
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Our COPD programme ran in April 2005 and in this article we provide further information and relevant updates from the literature.
Key messages
- Bronchodilators are beneficial even if there is no evidence of airway reversibility. There is evidence that they reduce air trapping (Price, 2005).
- Long acting bronchodilators (tiotropium or long acting beta-2 agonists - LABA) may improve symptom control when patients continue to have symptoms or deteriorate despite the use of short acting bronchodilators. With respect to improvements in health outcomes, no consistent differences have been identified between LABA (salmeterol or eformoterol) and tiotropium. Tiotropium may be better tolerated than a LABA. If a long acting bronchodilator is indicated a LABA would only be considered if the patient is unable to tolerate or does not respond to tiotropium.
- Inhaled corticosteroids (ICS) do not slow the rate of decline in lung function associated with COPD but they do slow the rate of exacerbations compared with placebo.
- ICS may reduce all cause mortality in COPD but there is currently insufficient evidence to change the recommended criteria for their use.
- Patients should be encouraged to exercise as it is likely to reduce the risk of hospital admission and mortality in patients with COPD.
- COPD patients who are still smoking should be offered help to stop at every opportunity.
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