The Pharmaceutical Journal
Vol 268 No 7203 p861-867
22 June 2002

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Alternative approach predicted for obstructive pulmonary disease

Future treatment of chronic lung disease will mirror the approach used in hypertension, a respiratory expert has predicted.

Speaking at conference in Birmingham on 14 June, Professor Bartolome Celli, pulmonary and critical care unit, St Elizabeth's Medical Centre, Tufts University School of Medicine, Boston, proposed that patients with chronic obstructive pulmonary disease (COPD) should take long-acting inhaled bronchodilators in a way similar to how patients with high blood pressure took long-acting antihypertensive agents.

He pointed out that a small reduction in blood pressure helped prevent serious consequences such as stroke and angina. Similarly, use of a long-acting muscarinic bronchodilator in COPD produced small improvements in lung function and was effective in reducing the distressing symptom of breathlessness and could help prevent patients experiencing exacerbations of disease, he said.

Professor Celli's stance on long-acting bronchodilators appeared to be endorsed by Professor Stephen Rennard, University of Nebraska medical centre, Omaha. Patients with COPD have permanent airflow limitation so should not be treated routinely with rescue medication, he said. Instead, they should be taking therapies such as long-acting bronchodilators to allow them to exercise more, not to treat the breathlessness resulting from exertion.