PREVENTION OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Acute exacerbation is a typical event in the natural course of chronic obstructive pulmonary disease (COPD). Acute exacerbation of COPD (AECOPD) is one of the most frequent causes for seeking the emergency aid by patients. Frequent AECOPD could deteriorate lung function and gaz exchange, cause more rapid progression of the disease and significant worsening of the patient's quality of life for long time (up to several weeks). AECOPD is associated with severe economic burden. Current therapeutic approaches can greatly reduce the risk of AECOPD. Effect of the basic therapy on exacerbation rate are related to such factors as the exacerbation cause (infection, spontaneous deterioration of inflammation, bronchoconstriction, etc.), severity of the disease (usually, therapy can decrease the risk of exacerbation in more severe patients), COPD phenotype, etc. Results  of clinical trials aimed at the reduction of exacerbation rate are also related to many of factors such as patients' population involved in the study, the previous rate of exacerbations, the study length, etc. Currently, no one therapeutic approach can completely eliminate the risk of exacerbations. The efficacy of different therapeutic methods in preventing AECOPD is 15% to 50%. Methods for preventing AECOPD can be divided to pharmacological and non-pharmacological ones. There is a need to search for target pharmacological approaches for preventing AECOPD including currently available drugs.