Optimal Treatment of Chronic Obstructive Pulmonary Disease: The Search for the Magic Combination of Inhaled Bronchodilators and Corticosteroids
Authors: Gerard J. Criner
Journal: Annals of Internal Medicine (2007)

Editorials17 April 2007Optimal Treatment of Chronic Obstructive Pulmonary Disease: The Search for the Magic Combination of Inhaled Bronchodilators and CorticosteroidsGerard J. Criner, MDGerard J. Criner, MDFrom Temple University School of Medicine, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-8-200704170-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Chronic obstructive pulmonary disease (COPD) is an international disease: Not only does it affect 10 to 24 million adults in the United States (1), but it is also the fourth leading cause of death in both the United States and the world (2). The global burden of COPD will increase dramatically in the coming years (3). A recent assessment by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) projects that COPD will be the fifth leading cause of disease worldwide and the third leading cause of death by 2020 (3).Chronic obstructive pulmonary disease is costly. In 2000, COPD ...References1. Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC. Chronic obstructive pulmonary disease surveillance—United States, 1971-2000. MMWR Surveill Summ. 2002;51:1-16. [PMID: 12198919] MedlineGoogle Scholar2. National Institutes of Health National Heart, Lung, and Blood Institute Fact Book, Fiscal Year 2002. Bethesda, MD: National Institutes of Health; 2003:35-53. Google Scholar3. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease: NHLBI/WHO Workshop Report. Bethesda, MD: National Heart Lung and Blood Institute, National Institutes of Health; April 2001. NIH publication no. 2701. Updated 2003/2004/2006. Accessed at www.goldcopd.com on 4 March 2007. Google Scholar4. Michaud CM, Murray CJ, Bloom BR. Burden of disease—implications for future research. JAMA. 2001;285:535-9. [PMID: 11176854] CrossrefMedlineGoogle Scholar5. Sin DD, Stafinski T, Ng YC, Bell NR, Jacobs P. The impact of chronic obstructive pulmonary disease on work loss in the United States. Am J Respir Crit Care Med. 2002;165:704-7. [PMID: 11874818] CrossrefMedlineGoogle Scholar6. Connors AF, Dawson NV, Thomas C, Harrell FE, Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996;154:959-67. [PMID: 8887592] CrossrefMedlineGoogle Scholar7. Seemungal TA, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157:1418-22. [PMID: 9603117] CrossrefMedlineGoogle Scholar8. DAFNE Study Group. Decisiones sobre Antibioticoterapia y Farmacoeconomía en la EPOC. Pharmacoeconomic evaluation of acute exacerbations of chronic bronchitis and COPD. Chest. 2002;121:1449-55. [PMID: 12006427] CrossrefMedlineGoogle Scholar9. ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23:932-46. [PMID: 15219010] CrossrefMedlineGoogle Scholar10. Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med. 2004;350:2645-53. [PMID: 15215480] CrossrefMedlineGoogle Scholar11. Retamales I, Elliott WM, Meshi B, Coxson HO, Pare PD, Sciurba FC, et al. Amplification of inflammation in emphysema and its association with latent adenoviral infection. Am J Respir Crit Care Med. 2001;164:469-73. [PMID: 11500352] CrossrefMedlineGoogle Scholar12. Shapiro SD. End-stage chronic obstructive pulmonary disease: the cigarette is burned out but inflammation rages on [Editorial]. Am J Respir Crit Care Med. 2001;164:339-40. [PMID: 11500330] CrossrefMedlineGoogle Scholar13. Mahler DA, Donohue JF, Barbee RA, Goldman MD, Gross NJ, Wisniewski ME, et al. Efficacy of salmeterol xinafoate in the treatment of COPD. Chest. 1999;115:957-65. [PMID: 10208192] CrossrefMedlineGoogle Scholar14. Dutch/Belgian Tiotropium Study Group. Improved health outcomes in patients with COPD during 1 yr's treatment with tiotropium. Eur Respir J. 2002;19:209-16. [PMID: 11871363] CrossrefMedlineGoogle Scholar15. TRial of Inhaled STeroids ANd long-acting beta2 agonists study group. Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2003;361:449-56. [PMID: 12583942] CrossrefMedlineGoogle Scholar16. Calverley PM, Boonsawat W, Cseke Z, Zhong N, Peterson S, Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Respir J. 2003;22:912-9. [PMID: 14680078] CrossrefMedlineGoogle Scholar17. Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J. 2003;21:74-81. [PMID: 12570112] CrossrefMedlineGoogle Scholar18. Dal Negro RW, Pomari C, Tognella S, Micheletto C. Salmeterol & fluticasone 50 microg/250 microg bid in combination provides a better long-term control than salmeterol 50 microg bid alone and placebo in COPD patients already treated with theophylline. Pulm Pharmacol Ther. 2003;16:241-6. [PMID: 12850128] CrossrefMedlineGoogle Scholar19. Niewoehner DE, Rice K, Cote C, Paulson D, Cooper JA, Korducki L, et al. Prevention of exacerbations of chronic obstructive pulmonary disease with tiotropium, a once-daily inhaled anticholinergic bronchodilator: a randomized trial. Ann Intern Med. 2005;143:317-26. [PMID: 16144890] LinkGoogle Scholar20. Aaron SD, Vandemheen KL, Fergusson D, Maltais F, Bourbeau J, Goldstein R, et al. Tiotropium in combination with placebo, salmeterol, or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease. A randomized trial. Ann Intern Med. 2007;146:545-55. LinkGoogle Scholar21. TORCH investigators. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007;356:775-89. [PMID: 17314337] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Temple University School of Medicine, Philadelphia, Pennsylvania.Disclosures: Consultancies: Ortho Biotech, Schering-Plough, Boehringer Ingelheim, Actelion, Shire Pharmaceuticals, Sepracor Pharmaceuticals; Honoraria: Ortho Biotech, Schering-Plough, Boehringer Ingelheim, Actelion, Shire Pharmaceuticals, Sepracor Pharmaceuticals; Grants received: Schering-Plough, Boehringer Ingelheim, Actelion, GlaxoSmithKline, Altana Pharma, Daiichi Asubio Pharmaceuticals, Pfizer Inc., Roche Pharmaceuticals, Sepracor Pharmaceuticals, Emphasys Medical Inc., Aeris Therapeutics Inc.; Grants pending: Boehringer Ingelheim, GlaxoSmithKline.Corresponding Author: Gerard J. Criner, MD, Pulmonary and Critical Care Medicine and Temple Lung Center, Temple University School of Medicine, 745 Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA 19140; e-mail, [email protected]temple.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTiotropium in Combination with Placebo, Salmeterol, or Fluticasone–Salmeterol for Treatment of Chronic Obstructive Pulmonary Disease Shawn D. Aaron , Katherine L. Vandemheen , Dean Fergusson , François Maltais , Jean Bourbeau , Roger Goldstein , Meyer Balter , Denis O'Donnell , Andrew McIvor , Sat Sharma , Graham Bishop , John Anthony , Robert Cowie , Stephen Field , Andrew Hirsch , Paul Hernandez , Robert Rivington , Jeremy Road , Victor Hoffstein , Richard Hodder , Darcy Marciniuk , David McCormack , George Fox , Gerard Cox , Henry B. Prins , Gordon Ford , Dominique Bleskie , Steve Doucette , Irvin Mayers , Kenneth Chapman , Noe Zamel , Mark FitzGerald , and Metrics 17 April 2007Volume 146, Issue 8Page: 606-608KeywordsBronchodilatorsChronic obstructive pulmonary diseaseHospitalizationsLungsMorbidityPneumoniaQuality of lifeStable coronary artery disease ePublished: 17 April 2007 Issue Published: 17 April 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...