Department of Internal Medicine, Krefting Research Centre, University of Gothenburg, Box 424, S-40530 Göteborg, Sweden.
Curr Opin Pharmacol. 2012 Jun;12(3):252-5. doi: 10.1016/j.coph.2012.03.004. Epub 2012 Mar 30.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality globally, and its prevalence is projected to continue to increase owing to trends in smoking. Treatment of COPD has evolved from the initial adaptations of drugs and treatment strategies successfully used in asthma into more specific pharmacological strategies following global guidelines. Bronchodilating anticholinergic and beta-2-stimulating agents and anti-inflammatory corticosteroid drugs delivered by inhalators are the mainstay of COPD treatment. Despite significant progress, current pharmacotherapies neither fully alleviate the airway obstruction in COPD, nor reverse the progressive nature of the disease. This review discusses inhalation therapies which have recently become clinically available or are being developed, with focus on combination therapies. There is accumulating evidence that the combination of two or all three drug classes, triple therapy, is superior to single drug therapy. Several fixed combinations of both currently available and novel molecules will be launched for clinical use within the next few years. Also, improved understanding of subgroups within the clinical spectrum of COPD, is likely to offer new potentials to improve COPD care.
慢性阻塞性肺疾病（COPD）是全球主要的发病率和死亡率原因，由于吸烟趋势，其患病率预计将继续增加。COPD 的治疗已经从最初成功应用于哮喘的药物和治疗策略的适应性转变为全球指南指导下更具针对性的药理学策略。通过吸入器给予的支气管扩张抗胆碱能和β2-激动剂以及抗炎皮质类固醇药物是 COPD 治疗的主要方法。尽管取得了重大进展，但目前的药物治疗既不能完全缓解 COPD 中的气道阻塞，也不能逆转疾病的进行性。本文讨论了最近在临床上可用或正在开发的吸入治疗方法，重点是联合治疗。越来越多的证据表明，两种或所有三种药物类别的联合治疗，三联疗法，优于单一药物治疗。在未来几年内，将推出几种现有和新型分子的固定组合用于临床应用。此外，对 COPD 临床谱内亚组的理解的提高，可能为改善 COPD 护理提供新的潜力。
