EMPHYSEMA AND COPD: DOS AND DON'TS

A very large population of the world including Americans have COPD WHICH STANDS FOR chronic obstructive pulmonary disease . It is a disease of the lungs that get damaged by SMOKING CIGARETTES.
IT IS A LEADING CAUSE OF DEATH.

Source : WHO.

Up until recent years, limited treatment choices were available and many approved treatments carried inhaled steroids and a LABA ( long acting beta agonist).

In 2015 EUROPEAN RESPIRATORY JOURNAL PUBLISHED THE FOLLOWING:

Inhaled corticosteroids in COPD: the clinical evidence:
Abstract

In this article, we focus on the scientific evidence from randomised trials supporting treatment with inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), including treatment with combinations of long-acting β-agonist (LABA) bronchodilators and ICS. Our emphasis is on the methodological strengths and limitations that guide the conclusions that may be drawn.

The evidence of benefit of ICS and, therefore, of the LABA/ICS combinations in COPD is limited by major methodological problems. From the data reviewed herein, we conclude that there is no survival benefit independent of the effect of long-acting bronchodilation and no effect on FEV1 decline, and that the possible benefit on reducing severe exacerbations is unclear. Our interpretation of the data is that there are substantial adverse effects from the use of ICS in patients with COPD, most notably severe pneumonia resulting in excess deaths.

Currently, the most reliable predictor of response to ICS in COPD is the presence of eosinophilic inflammation in the sputum. There is an urgent need for better markers of benefit and risk that can be tested in randomised trials for use in routine specialist practice. Given the overall safety and effectiveness of long-acting bronchodilators in subjects without an asthma component to their COPD, we believe use of such agents without an associated ICS should be favoured.

THIS IS ONE OPINION AND A GOOD ONE AND TREATMENT PLANS SHOULD CONSIDER THIS. ICS= inhaled corticosteroids
THERE ARE MANY NEW ALTERNATIVES AVAILABLE IN THE PAST FEW YEARS. Although this post is not about favoring one drug or the other but the newer combinations have a great place in the treatment of COPD. Some examples of treatments available now without the inhaled steroids are as follows

1. ANORO
2. STIOLTO
3. UMRCLIDINIUM
   ETC.

ALSO there have been advances for patients with COPD who have multiple flareups also known as EXACERBATIONS

1. Daily dose of Zithromax tends to decrease the frequency of flareups
2. Daily dose of Daliresp helps decrease the frequency of flareups

PULMONARY REHAB is done in an outpatient setting and it is of great value to patients to increase their quality of life and many patients can do a whole lot more with less shortness of breath upon completion of this program .

When you go to your doctor and you have 15 to 20 minutes to discuss your situation and get treatment perhaps a few things may not be discussed in detail. It serves the patient well to be knowledgeable about the condition. I present this information for people with COPD to review and research so you are better prepared next time you see your physician .

In my coming post I will comment on stem cell therapy for lung disease. Cautionary statement. It is UNPROVEN THERAPY.