Chronic obstructive pulmonary disease or COPD is a difficult disease to treat with no known cure. However, with recent developments in the medical field, more tools at their disposal, and more knowledge about cellular functions, researchers are exploring new treatment options.
8 new treatments for COPD
Bronchial rheoplasty
Bronchial rheoplasty is a new bronchoscopic method for the management of chronic bronchitis. The clinician inserts a specialized camera called a bronchoscope into the lungs, then delivers short bursts of electrical energy to the inner walls of the small and larger airways called the bronchi. The electrical bursts cause the excessive mucus-producing cells to break open and die, which helps regenerate healthy cells in the lungs.
Targeted lung denervation (TLD)
TLD is a bronchoscopic intervention designed to disrupt pulmonary nerve reflexes, which may have the potential to reduce COPD exacerbation (a symptom flare-up commonly referred to as a lung attack). The development of interventional therapies such as TLD may stabilize COPD patients and help reduce their risk of exacerbation.
Stem cell therapy
Stem cells are undifferentiated cells with the ability to become specialized cells. Theoretically, these cells can replace diseased cells and help repair and regenerate organs. There have been promising results with the use of stem cells in animal models of lung diseases. Although the U.S. FDA has approved human clinical trials for stem cell use in COPD, there is no information yet about their long-term safety or efficacy.
Lung flute
This device helps clear excess mucus in the lung and is the only product that uses sound vibration to stimulate the body's natural mucus-clearing system. The technology is based on the use of low-frequency acoustic waves. Unlike other technologies, this device reaches into the lower airways to clear secretions deep in the lungs. The device is also reusable, noninvasive, and drug-free.
Clinical tests have proven that the lung flute can break up mucus in the lungs, making it effective for diagnostic use and therapy.
Robotic lung volume reduction surgery
Traditional lung volume reduction surgery (LVRS) involves making a large chest incision to access the lungs to dissect the parts of the lungs that are diseased and dilated. The robotic device requires just three small incisions on the right side of the chest to successfully achieve the same results with no additional scarring as well as minimized infection risk and reduced risk of complications, such as bleeding and post-surgical thrombosis (blood clot formation).
The robotic device consists of three robotic arms and a special arm that carries a three-dimensional camera. The technology uses a high-definition screen that allows a more detailed three-dimensional view of the operating area. The arms are precisely controlled by the surgeon as they perform the procedure.
Valve surgery
During valve surgery, the surgeon uses a bronchoscope to put a one-way valve in the airway. This allows the overexpanded part of the lung to release air out of the airway but does not let air in. However, the patient must have damage in the right area of the lung for the valve to work.
Other methods to block off airways and keep sacs from overextending, such as putting in tiny coils, are being tested to see if their benefits outweigh the risks.
Azithromycin
Studies have shown a common antibiotic called azithromycin may reduce the number of flare-ups in patients with COPD. However, it is not advised in all cases. The antibiotic reduced flare-ups by about 20% in a selected group of patients.
Interleukin 5 (IL-5) drugs
A new group of biologic drugs called IL-5 antagonists (such as mepolizumab) may work well for COPD patients. New trials of the drugs for people with COPD and high eosinophil counts look promising.
What are current treatment options for COPD?
Treatment for COPD can ease symptoms, prevent complications, and generally slow disease progression. Therapies include:
- Medication:
- Bronchodilators: These medications help relax the muscles of the airways, widening them so that the patient can breathe easier. They are usually taken through an inhaler or a nebulizer. Glucocorticosteroids are also added to reduce inflammation in the airways.
- Combination therapy: COPD medications can be used together to provide more relief from symptoms. Both long-acting beta-2 agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) make airways smaller. A patient may start with a LABA and add a LAMA later or start both drugs together.
- Phosphodiesterase-4 inhibitors: This type of medication can be taken in pill form to help reduce inflammation and relax the airways. It’s generally prescribed for severe COPD with severe bronchitis.
- Theophylline: Available in pill form, this medication eases chest tightness and shortness of breath and may also help prevent flare-ups. Theophylline is an older medication that may cause side effects. It’s generally not a first-line treatment for COPD therapy.
- Antibiotics and antivirals: Antibiotics or antivirals may be prescribed when the patient develops certain respiratory infections.
- Vaccines: Doctors usually recommend getting an annual flu shot, such as the pneumococcal or the whooping cough vaccine, to avoid respiratory infections.
- Oxygen therapy: Supplemental oxygen is given to the patient through a mask or nasal cannula to help them breathe better.
- Surgery: Surgery is considered when other treatments have failed, which is more likely when the patient has severe respiratory failure.
- Bullectomy: Large, abnormal air spaces (bullae) are removed from the lungs.
- Lung volume reduction surgery: This procedure removes damaged upper lung tissue.
- Lung transplantation: This procedure is an option only in rare cases.
QUESTION
COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma. See AnswerIkonomou L, Panoskaltsis-Mortari A, Wagner DE, Freishtat RJ, Weiss DJ; American Thoracic Society Respiratory Cell and Molecular Biology Assembly Stem Cell Working Group. Unproven Stem Cell Treatments for Lung Disease-An Emerging Public Health Problem. Am J Respir Crit Care Med. 2017 Apr 1;195(7):P13-P14. https://www.thoracic.org/patients/patient-resources/resources/stem-cell-therapy.pdf
Health Europa. Innovation in the treatment of COPD. https://www.healtheuropa.eu/innovation-in-the-treatment-of-copd/96981/
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