Advances in COPD Treatment

Photo Credit: Ikon Images/Mark Airs.

The therapies described below are typically utilized when standard medical management (such as inhalers, pulmonary rehabilitation, oxygen, etc) have failed to improve symptoms. To date, there are no therapies that cure COPD. Be wary of ‘experimental treatments’ that claim to reverse COPD.  Unfortunately, there are many websites that make claims aimed at vulnerable patients who may feel like they have no other options.

Remember, experimental therapies should only be administered in the context of a clinical research study, which means that there is an overseeing regulatory body, called an Institutional Review Board. Below are some options for patients with moderate to severe COPD who have not responded to classic medical therapies.

  1. New Medications. Recently, two new pills have been established as helpful in patients who have moderate to severe COPD and frequent exacerbations. The first, called azithromycin, is an antibiotic that also has anti-inflammatory effects that decrease COPD exacerbations and improve quality of life. The second, called roflumilast, may help reduce COPD exacerbations for patients with chronic bronchitis. Although neither of these medications has been shown to improve lung function per se, they have both been shown to keep patients out of the hospital and improve symptoms, which in terms of quality of life, can be a pretty big deal. Both of these medications are FDA approved to treat COPD and have been vetted by multiple clinical trials.
  1. Surgery. Lung volume reduction surgery is an option for patients have low exercise capacity and whose COPD predominantly affects the upper portion of the lungs. In these specific kinds of patients, lung volume reduction surgery is an option for treating COPD. The effectiveness of this surgery in this circumstance was established after the NETT (National Emphysema Treatment Trial) trial was published in the scientific literature in 2003. 
  1. Endobronchial Valves. For patients who may not wish to endure surgery, new devices called ‘endobronchial valves’ may be an alternative. The valves are placed by a procedure called a ‘bronchoscopy’ (similar to a colonoscopy) in which a camera is inserted into the airway that allows the physician to see the inside of the lung and deploy the valve. No cutting of tissue is required for this procedure. In essence, the valve cuts off the ‘diseased lung’ and diverts air into the healthy lung. This new procedure is still under investigation but has been shown to improve symptoms for many who have valves placed. Clinical studies are ongoing, but this therapy has been well vetted by several previous clinical trials. The EMPROVE trial is actively enrolling at the time of this article, and information about the trial can be found here.

These are some of the most well-vetted and important advances in COPD therapy at this time.  The amount of research ongoing to help patients with COPD is impossible to summarize in a single article (or even a volume of articles!) but for those seeking alternative therapies you can use the information and resources in this series to help make informed decisions about how best to pursue non-traditional therapies for COPD.

Note that there is NO INFORMATION in this series regarding Stem Cell therapy for the treatment of COPD.  This is a very deliberate choice because to date, there have been no clinical studies to support the claims of the many websites claiming that Stem Cells can reverse disease progression in COPD.  The position of most professional societies on the use of Stem Cells in COPD is that while stem cell treatment in lung diseases warrants further investigation, it is NOT recommended that patients enroll in expensive programs that offer stem cell therapy for COPD. The FDA does NOT regulate stem cell use in patients with lung disease and there is a lack of high-quality, published research that has established safety or effectiveness of this potentially dangerous intervention.

There are safe options for patients with COPD who wish to seek alternative therapies for COPD, and we hope this series helps patients navigate the challenges of deciding when to try new therapies. ALWAYS consult a pulmonologist prior to taking alternative therapies for COPD, and when in doubt, get a second opinion from a reputable, independent healthcare provider who can provide you with an honest, informed, and unbiased opinion.

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