Treating COPD Early Improves Outcomes

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For the best outcomes, Decramer said, COPD needs to be diagnosed in its early stages, and aggressive therapy should begin as soon as possible.

"We need to treat these patients earlier than we presently do," Decramer said.

Dr. Norman Edelman, chief medical officer of the American Lung Association, agreed that the findings highlight the need to start COPD treatment when the illness is still mild.

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"The major new finding is the efficacy of an anticholinergic in patients with relatively mild COPD in improving lung function and quality of life," Edelman said. "The effects were small but seem real. This is of significance because it points out the usefulness of case finding and treatment of relatively early COPD cases, a somewhat neglected area in clinical practice."

Two other reports in the same edition of the journal show the benefit of the new drug roflumilast (Daxas) in treating COPD.

Daxas, an anti-inflammatory, is still going through the drug approval process in the United States and elsewhere.

In one study, Dr. Leonardo Fabbri from the University of Modena in Italy and colleagues randomly assigned 3,091 patients with severe COPD to Daxas or a placebo. Over a year, patients taking Daxas experienced improved lung function and had 17 percent fewer flare-ups than patients taking a placebo.

"These results suggest that different subsets of patients exist within the broad range of COPD, and that targeted specific therapies could improve disease management," the researchers concluded.

In a second report, a research team led by Dr. Klaus F. Rabe, of Leiden University Medical Center in the Netherlands, tested the benefit of Daxas when added to standard COPD treatment with long-acting bronchodilators or anticholinergics.

In this trial, 1,677 patients with moderate-to-severe COPD were randomly assigned to Daxas or a placebo for 24 weeks. Patients were also receiving the bronchodilator salmeterol (Serevent) or the anticholinergic Spiriva.

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