최근 대규모 만성폐쇄성폐질환 임상연구의 해석과 적용
Interpretation and application of recent large clinical studies in COPD
2
조회
0
다운로드
0
인용
0
참고문헌
초록
Chronic obstructive pulmonary disease (COPD) shows a high mortality as well as a high prevalence around the world. Recent large-scale clinical studies showed that inhaled long-acting anticholinergics, inhaled long-acting β2-agonists, and inhaled corticosteroid have beneficial effects on patients suffered from COPD. In addition, the combination of the two or three inhalers above shows more beneficial effects. The beneficial effects are the improvement of symptom, lung function, and quality of life as well as the reduction of exacerbation and possibly death. These beneficial effects are true not only for the patients with severe and very severe COPD but also for the patients with moderate COPD. Clinical studies also showed that mucolytics and roflumilast, a new anti-inflammatory drug have beneficial effects on the patients with COPD. According to these beneficial results proven by the recent clinical studies, the guidelines for the management of COPD might be revised to promote the usage of the beneficial drugs for the patients with COPD. The promoted usage of the COPD drugs would help the COPD patients to overcome their symptom, limitation of airflow and frequent exacerbation and also to improve their quality of life.
Abstract
Chronic obstructive pulmonary disease (COPD) shows a high mortality as well as a high prevalence around the world. Recent large-scale clinical studies showed that inhaled long-acting anticholinergics, inhaled long-acting β2-agonists, and inhaled corticosteroid have beneficial effects on patients suffered from COPD. In addition, the combination of the two or three inhalers above shows more beneficial effects. The beneficial effects are the improvement of symptom, lung function, and quality of life as well as the reduction of exacerbation and possibly death. These beneficial effects are true not only for the patients with severe and very severe COPD but also for the patients with moderate COPD. Clinical studies also showed that mucolytics and roflumilast, a new anti-inflammatory drug have beneficial effects on the patients with COPD. According to these beneficial results proven by the recent clinical studies, the guidelines for the management of COPD might be revised to promote the usage of the beneficial drugs for the patients with COPD. The promoted usage of the COPD drugs would help the COPD patients to overcome their symptom, limitation of airflow and frequent exacerbation and also to improve their quality of life.
참고문헌 (34)
- Lopez AD, "Chronic obstructive pulmonary disease: current burden and future projections", Eur Respir J, 27, pp.397~412 (2006)
- "Report world health"[URL]
- "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease" (2008)[URL]
- Cazzola M, "American Thoracic Society", European Respiratory Society Task Force on outcomes of COPD. Outcomes for COPD pharmacological trials: from lung function to biomarkers, 2008, pp.31, 416~469
- Casaburi R, "A long‐term evaluation of once‐daily inhaled tiotropium in chronic obstructive pulmonary disease", Eur Respir J, 19, pp.217~224 (2002)
- O’Donnell DE, "Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD", Eur Respir J, 23, pp.832~840 (2004)
- Tashkin DP, "UPLIFT Study Investigators. A 4‐year trial of tiotropium in chronic obstructive pulmonary disease", N Engl J Med, 359, pp.1543~1554 (2008)
- Lee TA, "Risk for death associated with medications for recently diagnosed chronic obstructive pulmonary disease", Ann Intern Med, 149, pp.380~390 (2008)
- Singh S, "Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a systematic review and metaanalysis", JAMA, 300, pp.1439~1450 (2008)
- Dahl R, "Formoterol in Chronic Obstructive Pulmonary Disease I Study. Inhaled formoterol dry powder versus ipratropium bromide in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 164, pp.778~784 (2001)
- Calverley PM, "Investigators. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease", N Engl J Med, 356, pp.775~789 (2007)
- Cazzola M, "The functional impact of adding salmeterol and tiotropium in patients with stable COPD", Respir Med, 98, pp.1214~1221 (2004)
- van Noord JA, "Comparison of tiotropium once daily, formoterol twice daily and both combined once daily in patients with COPD", Eur Respir J, 26, pp.214~222 (2005)
- van Noord JA, "Effects of tiotropium with and without formoterol on airflow obstruction and resting hyperinflation in patients with COPD", Chest, 129, pp.509~517 (2006)
- Rabe KF, "Comparison of a combination of tiotropium plus formoterol to salmeterol plus fluticasone in moderate COPD", Chest, 134, pp.255~262 (2008)
- Vestbo J, "Longterm effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial", Lancet, 353, pp.1819~1823 (1999)
- Pauwels RA, "Long‐term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking: European Respiratory Society Study on Chronic Obstructive Pulmonary Disease", N Engl J Med, 340, pp.1948~1953 (1999)
- Burge PS, "Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial", BMJ, 320, pp.1297~1303 (2000)
- Lung Health Study Research Group, "Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease", N Engl J Med, 343, pp.1902~1909 (2000)
- Sin DD, "Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease", Thorax, 60, pp.992~997 (2005)
- Lofdahl C‐G, "Possible protection by inhaled budesonide against ischaemic cardiac events in mild COPD", Eur Respir J, 29, pp.1115~1119 (2007)
- Calverley P, "Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial", Lancet, 361, pp.449~456 (2003)
- Szafranski W, "Efficacy and safety of budesonide", formoterol in the management of chronic obstructive pulmonary disease, 2003, pp.21, 74~81
- Calverley PM, "Maintenance therapy with budesonide and formoterol in chronicobstructive pulmonary disease", Eur Respir J, 22, pp.912~919 (2003)
- Celli BR, "Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH Study", Am J Respir Crit Care Med, 178, pp.332~338 (2008)
- Wedzicha JA, "INSPIRE Investigators. The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol", fluticasone propionate or tiotropium bromide, 2008, pp.177, 19~26
- Aaron SD, "Canadian Thoracic Society", Canadian Respiratory Clinical Research Consortium. Tiotropium in combination with placebo, salmeterol, or fluticasone salmeterol for treatment of chronic obstructive pulmonary disease: a randomized trial, 2007, pp.146, 545~555
- formoterol added to tiotropium in COPD patients, "Efficacy and tolerability of budesonide", pp.2009, Welte T
- Decramer M, "Effects of N‐acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost‐Utility Study, BRONCUS): a randomised placebo‐controlled trial", Lancet, 365, pp.1552~1560 (2005)
- Zheng JP, "Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo‐controlled study", Lancet, 371, pp.2013~2018 (2008)
- Rabe KF, "Roflumilast: an oral anti‐inflammatory treatment for chronic obstructive pulmonary disease: a randomised controlled trial", Lancet, 366, pp.563~571 (2005)
- Calverley PM, "Effect of 1‐year treatment with roflumilast in severe chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 176, pp.154~161 (2007)
- Jorenby DE, "Varenicline Phase 3 Study Group. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained‐release bupropion for smoking cessation: a randomized controlled trial", JAMA, 296, pp.56~63 (2006)
- Nides M, "Smoking cessation with varenicline, a selective alpha4beta2 nicotinic receptor partial agonist: results from a 7‐ week, randomized, placebo‐ and bupropion‐controlled trial with 1 ‐year follow‐up", Arch Intern Med, 166, pp.1561~1568 (2006)