HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Buhl, R. Articles by Farmer, S. G. Search for Related Content PubMed PubMed Citation Articles by Buhl, R. Articles by Farmer, S. G.

Future Directions in the Pharmacologic Therapy of Chronic Obstructive Pulmonary Disease

Mainz University Hospital, Mainz, Germany; and AstraZeneca Pharmaceuticals, Wilmington, Delaware

Correspondence and requests for reprints should be addressed to Roland Buhl, M.D., Mainz University Hospital, Langenbeckstrasse 1, Mainz, D-55131, Germany. E-mail: r.buhl{at}3-med.klinik.uni-mainz.de

Current therapy for chronic obstructive pulmonary disease (COPD) fails to alter its relentless progression. This remains a significant challenge and unmet need. A recent advance is the demonstration that treatment with a fixed dose of an inhaled corticosteroid and a long-acting ß₂-agonist in COPD improves lung function and quality of life, and reduces exacerbation more effectively than either drug alone. Other improvements include the introduction of tiotropium, a once-daily anticholinergic. In advanced clinical development are other once-daily bronchodilators and combinations of anticholinergic drugs and ß₂-agonists. Increased understanding of the pathogenesis of COPD has led to novel drugs aimed at inhibiting targets, including phosphodiesterase 4, proteases, and various inflammatory mediators. Furthermore, COPD is increasingly seen as a systemic disorder or, indeed, may be a pulmonary manifestation of a complex pathophysiologic response to chronic inhalation of toxic irritants and associated with aging. Future therapy may involve better understanding of how best to target existing drugs used to treat cardiovascular disorders associated with smoking, such as atherosclerosis and hypercoagulability, and the development of new drugs that target systemic and metabolic manifestations that either result from or coexist with chronic lung inflammation, hypoxia, and cardiovascular disease in COPD.

Key Words: COPD • drug development • pulmonary inflammation • systemic inflammation • therapy

This article has been cited by other articles:

				R. A. McIvor Future options for disease intervention: important advances in phosphodiesterase 4 inhibitors Eur. Respir. Rev., September 1, 2007; 16(105): 105 - 112. [Abstract] [Full Text] [PDF]