Cutting edge of COPD therapy: current pharmacological therapy and future direction

Chronic obstructive pulmonary disease (COPD) is a common global health problem with increasing incidence and mortality. Therefore, attempting to increase the awareness of COPD and disseminate an effective system of management for COPD is important for human health. The management of stable COPD should be based on the disease severity, which is assessed by the severity of airflow limitation, symptoms and risk of exacerbations. The current mainstay of COPD therapy is bronchodilators. Recent advances in the development of both long-acting muscarinic receptor antagonists (LAMAs) and long-acting β2-adrenergic receptor agonists (LABAs) enable us to not only improve lung function, symptoms and quality of life, but also decrease the frequency of exacerbations and curb the rate of progression of airflow limitation. Because there are clinical phenotypes of COPD which have increased airway inflammation, inhaled corticosteroids are likely considered for a supplemental medicine added to an optimal long-acting inhaled bronchodilator regimen for frequent exacerbators and patients with the overlap COPD-asthma phenotype. To establish novel COPD therapies that can considerably reduce the disease progression and mortality as well as the comorbidities associated with COPD, new therapeutic targets that are involved in the pathophysiology of COPD are being investigated.