Figueira-Gonçalves Juan Marco, Callejas-González Francisco Javier, Golpe Rafael, Máiz-Carro Luis, Marín-Oto Marta, de Miguel-Díez Javier, Loscertales-Vacas Guillermo Samuel, Tordera-Mora José María, Hurtado-Fuentes Álvaro
Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
Department of Respiratory Medicine, Albacete University Hospital Complex, Albacete, Spain.
Open Respir Arch. 2025 May 7;7(2):100438. doi: 10.1016/j.opresp.2025.100438. eCollection 2025 Apr-Jun.
Prevention of exacerbations is a key objective in chronic obstructive pulmonary disease (COPD) management. The adverse effects of an exacerbation include a negative impact on patient quality of life and symptoms, an accelerated rate of decline in lung function, hospital admissions, and increased mortality. Clinical guidelines related to COPD management recommend smoking cessation and inhaled therapy (bronchodilators with or without corticosteroids) as the mainstay for these patients. Apart from the above-mentioned treatment, other potential therapies, such as mucolytic agents, antibiotics (oral or inhaled), phosphodiesterase-4 inhibitors or vaccination, are available and have been shown to reduce the incidence of exacerbations. In this brief narrative review, we will examine the efficacy of various treatments for preventing COPD exacerbations, beyond the use of bronchodilator therapy and inhaled corticosteroids.
预防急性加重是慢性阻塞性肺疾病(COPD)管理的关键目标。急性加重的不良影响包括对患者生活质量和症状产生负面影响、肺功能下降加速、住院以及死亡率增加。与COPD管理相关的临床指南推荐戒烟和吸入治疗(使用或不使用皮质类固醇的支气管扩张剂)作为这些患者的主要治疗方法。除上述治疗外,其他潜在疗法,如黏液溶解剂、抗生素(口服或吸入)、磷酸二酯酶-4抑制剂或疫苗接种,也可供使用,并已证明可降低急性加重的发生率。在这篇简短的叙述性综述中,我们将探讨除使用支气管扩张剂治疗和吸入皮质类固醇之外的各种预防COPD急性加重治疗方法的疗效。