Transcript COPD - American Lung Association

Welcome to the 1st
Patient and Caregiver Support Series
COPD: Support for Today,
Solutions for Tomorrow
To Join the Audio Conference:
Dial (646) 216-7221 | (866) 200-6965
Participant PIN Code: 29739952#
Moderators
Kristin DiFoglio, MPA
Assistant Vice President, Development
American Lung Association
Elizabeth Lancet, MPH
Assistant Vice President, Research
American Lung Association
You are not ALONE
•
15 million diagnosed with COPD; up to 24 million with
impaired lung function
•
As the baby boomer population enters their golden
years, COPD is expected to be an issue for many
•
Isolating / diagnosing COPD is difficult
•
Diagnostic testing not always done well or often
enough in primary care settings
•
Influence of stigma
Guest Speaker
Joe Ramsdell, MD
Professor of Medicine
University of California San Diego
Smoking and COPD:
Inflammation Leads to Tissue Destruction
What is the medical and research community
doing to help patients and caregivers with COPD?
Smoking Cessation and the
Natural History of COPD
FEV1.0 (%)
100
Nonsmoker
75
50
25
0
20
Smoker
Symptoms
Disability
Death
30
40
50
Age (Years)
60
70
80
Bronchodilators: Lots of Choices
• What they do:
– May reduce inflammation and swelling
– Relax the airways of the lungs making it easier
to breathe
• Common Benefits: decrease in symptoms &
hospitalization for exacerbations
• Options include:
– Short-acting (albuterol, levalbuterol,
ipratropium): provides quick or "rescue" relief
from acute tightening
– Long-acting (salmeterol, fometerol,,
tiotropium, aclidinium, theophylline): help to
control and prevent symptoms
Corticosteroids
• What they do: Decreases inflammation in the
airways (reducing swelling and mucus
production), making breathing easier
• Common Benefits: improves lung function;
decreases symptoms, hospitalizations for
exacerbations & incidence of treatment failures
• Can be given orally or inhaled
• Options include: beclomethasone, fluticasone,
budesonide , combinations with bronchodilators
(budesonide and formoterol, fluticasone and
salmeterol)
Other Drugs
• Romfumlast: reduces the risk of exacerbation and improves
airflow
– Common Benefits: improves lung function; decreases
symptoms, hospitalizations for exacerbations & incidence
of treatment failures
– A once a day pill
• Mucolytics: improve mucus layer, usefulness is not clear
Pulmonary Rehabilitation
American Thoracic Society/European Respiratory Society
Statement on Pulmonary Rehabilitation
• Evidence-based exercise program
• Proven benefits from endurance and
strength training
– reduces shortness of breath
– increases exercise performance
– improves quality of life
– Reduced healthcare utilization
Effects of Pulmonary Rehabilitation after
Hospital Admission for an Exacerbation
Adapted from Seymore, J, Moore L, Jolley CJ, et al. Outpatient pulmonary
rehabilitation following acute exacerbations of COPD. Thorax. 2010;65:423-428.
Oxygen & Surgery – For Severe COPD
• Oxygen recommended for those with
PaO2 ≤ 55mmHg or SaO2 ≤ 88%
• Lung Volume Reduction Surgery
(LVRS) reduces the size of the lungs
by removing about 20-30% of the
most diseased lung tissues so that the
healthier portion can perform better
• Lung transplants are a last resort
treatment for irreversible lung failure
Emerging Research on
Smoking/COPD connection
• COPD Clinical Research Network – understanding the best
treatments for COPD
• COPDGene – understanding the causes and consequences
of smoking
• ALA Asthma Clinical Research Centers SAPS –
understanding the best treatment for smoking in asthma
Drugs in the Pipeline
• Antibiotics (Low dose continuous
azithromycin, intermittent
fluoroquinolones)
• New combinations (Corticosteroids and
tiotropium, bronchodilator combinations)
• Protease inhibitors
• Statins
• Vasodilators (sildenafil)
• Anti-inflammatories (anti-leukotriene)
• Biological anti-inflammatory agents
(mixed results)
• Growth factors
Emerging Research on
Pulmonary Rehabilitation
•
•
•
•
•
•
•
Chronic oxygen use
Patient selection
Effects on depression, quality of life
Home-based
Muscle-training (transcutaneous neuromuscular stimulation)
Use of oxygen
New approaches to surgery (bullectomy, bronchial stenting,
bronchoalveolar fenestration)
Participation in Clinical Trials
• Only way to identify useful therapeutics
– Identify successes as well as failures (Infliximab, retinoids)
• Update on COPDGene
– New candidate genes
– New understandings of pathophysiology in classification
of COPD
Conclusions
• Current drugs are effective in treating symptoms, but disease
modifying drugs are still not available
• Behavioral, rehabilitation and surgical approaches improve
quality of life and functional ability
• Research requires participation of physicians, nurses and
patients with COPD if progress is to be made.
Be an active participant –
volunteer for a COPD trial!
What is the American Lung Association doing for COPD
patients and their caregivers? – Self-Management Tools
What is the American Lung Association doing for COPD
patients and their caregivers? –Support Groups
What is the American Lung Association doing for COPD
patients and their caregivers? – COPD Action Plan
5 easy steps you can take today:
1.
Learn more! www.lung.org 1-800-LUNGUSA
2.
Bring the COPD Action Plan to your doctor
3.
Attend a Better Breathers Club
4.
Join the Lung Connection
5.
Get a Flu Shot!
Guest Speakers
Bill and Katherine Carroll
COPD Patient and Caregiver
Beth Slick
BBC Facilitator
Leonardtown, Maryland
Type your
questions into
the chat box!
Thank you!
For more information:
1. Look out for our follow up email with answers to your
questions and links to additional resources
2. Call our Lung Helpline at 800-LUNG-USA with any
medical questions
3. Visit the Lung Association’s COPD webpage to learn
more and join a support group:
www.lung.org/lung-disease/copd