COPD needs a different type of treatment

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June 18, 2019 - 10:02 AM

Dear Dr. Roach: I read your recent column on pulmonary fibrosis. I especially appreciate knowing that there are medications known to slow progression of lung disease, reduce exacerbations and reduce mortality. With a 20-year-old diagnosis of COPD and having been prescribed medications to reduce exacerbations, you might imagine my interest in your article.

I’m wondering how pulmonary fibrosis differs from COPD and if the two medications that you mention (pirfenidone and nintedanib) might be helpful in slowing the progression of lung disease in patients such as myself. Have any studies been completed using these medications on patients with COPD? — S.A.

Answer: Chronic obstructive pulmonary disease — its two main forms are emphysema and chronic bronchitis — usually, but not invariably, is a result of long-term exposure to lung toxins, especially smoke. In the most common case of COPD, due to cigarette smoking (at least, that’s the most common in North America and Europe: cooking fires are still a common cause in less developed countries), stopping the exposure will dramatically slow down further damage. Unfortunately, there are no established treatments that can restore lung function in people with moderate to advanced COPD.

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