Potential Future Therapies for COPD and Final Thoughts

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The MD Magazine Peer Exchange “Expanding Treatment Options: The Latest Developments in COPD Therapy” features a panel of physician experts discussing key topics in COPD therapy, including risk factors, personalized treatment, preventive measures, new combination therapies, and more.

This Peer Exchange is moderated by Peter Salgo, MD, professor of medicine and anesthesiology at Columbia University and an associate director of surgical intensive care at the New York-Presbyterian Hospital in New York City.

The panelists are:

• Byron Thomashow, MD, professor of medicine at Columbia University Medical Center, medical director at the Jo-Ann LeBuhn Center for Chest Disease at New York-Presbyterian Hospital, and chairman of the board of the COPD Foundation
• Neil R. MacIntyre, MD, clinical chief of the Pulmonary/Critical Care Division, medical director of Respiratory Care Services, and professor of medicine at Duke University School of Medicine
• Barry J. Make, MD, director of Pulmonary and Respiratory Care for National Jewish Health and professor of medicine at the University of Colorado School of Medicine
• Nicola A. Hanania, MD, MS, associate professor of medicine and director of the Asthma and COPD Clinical Research Center at Baylor College of Medicine

Some alternative interventions being studied right now for COPD include oxygen therapy and noninvasive ventilators, said MacIntyre, but they are far from ready for prime time. Regarding currently available treatment option, Thomashow said that he is surprised that lung volume reduction surgery has all but disappeared, considering the NET trial showed improvements in quality of life, exercise capacity, and survival rates of 99% at 1 year, 99% at 3 years, and 75% at 5 years in a well-selected population of patients.

Stem cells are also being considered as a potential avenue for lung regeneration, but their use is associated with many scientific, ethical, and political issues, of course. Thomashow stressed though that stem cells are not only embryonic cells; they can also be mesenchymal or adipose-derive stem cells. There may be hope for this approach in the distant future, but, in his opinion, we are not there yet.

In conclusion, the panelists offered the following final thoughts about COPD. Hanania wanted to remind the audience of the heterogeneity of the disease, as well as finding out the patient’s needs before deciding on a treatment plan. MacIntyre stressed the importance of pulmonary rehabilitation as a disease management program. Make said that we don’t spend enough time on patient education, which needs to be highly individualized. Finally, Thomashow said that physicians need to be more aggressive to give patients the lives they deserve, and that much more research should be devoted to this disease.