5 Therapies That Have Been Shown To Prolong Life in COPD

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Living with COPD is not an easy feat. Many patients with COPD struggle with bothersome symptoms such as shortness of breath, cough, fatigue, inability to exert oneself, and frequent pneumonias (among others). What’s worse is that the lung damage that results from COPD, whether it be emphysema or chronic bronchitis (which are both types of COPD), is irreversible. That is, once the damage is done and the lung function has dropped, patients with COPD cannot regain that lost lung function.

Some medications, such as tiotropium, are very effective in reducing symptoms of COPD while other medications, such as the inhaled steroids (eg. advair, symbicort) and other medications (e.g. azithromycin) may help reduce the amount of COPD patients exacerbations. Unfortunately, however, none of the COPD medications have been shown to lengthen the life of patients with COPD as a result of their use.

Though the National Heart, Lung, and Blood Institute continues to fund research into COPD and we hope to develop innovative and effective therapies, for now, only four therapies have been shown to prolong the lives of patients with COPD. They are:

  1. The flu shot. Patients with COPD who get their annual flu shot are more likely to live longer than those who do not. For more information about the value of the Flu shot (influenza shot) for patients with COPD, see this article.
  2. The pneumonia vaccine. There are two pneumonia vaccines. One is called Prevnar 13, and the other is commonly called "pneumovax" (pneumococcal vaccine). Research has shown that patients who take the pneumovax tend to live longer than those who do not get the vaccine. The pneumovax is given to patients COPD who may be younger than 65. Patients with COPD who got the pneumovax before the age of 65 and at least 5 years has past since that time, should get a second vaccination. In addition, the other vaccine, Prevnar 13, which is a newer vaccine, is given to patients with COPD who are 65 years or older and only needs to be given once. Check with your physician for the most recent guidelines because at the time of this article, these recommendations are in flux.
  1. Aggressive management for patients who become hospitalized with COPD exacerbations. This involves intravenous steroids, antibiotics, and nebulizers.
  2. Lung volume reduction surgery. Although only a small fraction of patients who have COPD qualify for lung volume reduction surgery, in very select patients, this procedure can help to prolong life. However, it’s important to note that if the surgery is performed in patients who do NOT meet the criteria (which includes having disease limited to the upper lobes of the lungs), then life may actually be shortened and symptoms worsened. Pulmonary specialists should evaluate all patients with COPD for criteria that may make them eligible for lung volume reduction surgery.
  1. Long-term oxygen therapy. Not all patients with COPD require oxygen, but for those that do, using long-term oxygen prolongs life. This was established by a research study called the NOTT trial, which found that those who used long-term oxygen therapy lived longer than comparable patients who did not. The criteria for oxygen is assessed by a pulse oximeter reading of less than 88% or a blood test that shows low levels of oxygen in the blood.

The bottom line

Staying up to date on vaccines and using oxygen when its prescribed can help patients with COPD to live longer, while inhalers and exercise may help patients with COPD live happier.

Sources

Macnee W. Prescription of oxygen: still problems after all these years. Am J Respir Crit Care Med 2005;172:517-8.

Croxton TL, Bailey WC. Long-term oxygen treatment in chronic obstructive pulmonary disease: recommendations for future research: an NHLBI workshop report. Am J Respir Crit Care Med 2006;174:373-8.

Mirsaeidi et. al. Pneumococcal Vaccines: Understanding Centers for Disease Control and Prevention Recommendations, Annals of the American Thoracic Society 2014 11:6, 980-985

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