Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids

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 mor...

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Main Authors: Juan Marco Figueira-Gonçalves, Francisco Javier Callejas-González, Rafael Golpe, Luis Máiz-Carro, Marta Marín-Oto, Javier de Miguel-Díez, Guillermo Samuel Loscertales-Vacas, José María Tordera-Mora, Álvaro Hurtado-Fuentes
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Open Respiratory Archives
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Online Access:http://www.sciencedirect.com/science/article/pii/S2659663625000426
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author Juan Marco Figueira-Gonçalves
Francisco Javier Callejas-González
Rafael Golpe
Luis Máiz-Carro
Marta Marín-Oto
Javier de Miguel-Díez
Guillermo Samuel Loscertales-Vacas
José María Tordera-Mora
Álvaro Hurtado-Fuentes
author_facet Juan Marco Figueira-Gonçalves
Francisco Javier Callejas-González
Rafael Golpe
Luis Máiz-Carro
Marta Marín-Oto
Javier de Miguel-Díez
Guillermo Samuel Loscertales-Vacas
José María Tordera-Mora
Álvaro Hurtado-Fuentes
author_sort Juan Marco Figueira-Gonçalves
collection DOAJ
description 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. Resumen: La prevención de las exacerbaciones es un objetivo clave en el tratamiento de la enfermedad pulmonar obstructiva crónica (EPOC). Los efectos adversos de una exacerbación incluyen un impacto negativo en la calidad de vida y los síntomas del paciente, un deterioro acelerado de la función pulmonar, un mayor riesgo de ingresos hospitalarios y un aumento de la mortalidad. Las guías de práctica clínica relacionadas con el tratamiento de la EPOC recomiendan el cese tabáquico y la terapia broncodilatadora con o sin corticosteroides inhalados como tratamiento base para estos pacientes. Aparte de los tratamientos mencionados, existen otras terapias potenciales, como son los agentes mucolíticos, los antibióticos (orales o inhalados), los inhibidores de la fosfodiesterasa-4 o la vacunación, entre otros, que han demostrado su papel en la prevención de las agudizaciones. En esta breve revisión narrativa examinaremos la eficacia de estos tratamientos más allá del uso de la terapia broncodilatadora y los corticosteroides inhalados.
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spelling doaj-art-6e7f8ab3181b458fb105cae92fafcdcc2025-08-20T02:09:18ZengElsevierOpen Respiratory Archives2659-66362025-04-017210043810.1016/j.opresp.2025.100438Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled CorticosteroidsJuan Marco Figueira-Gonçalves0Francisco Javier Callejas-González1Rafael Golpe2Luis Máiz-Carro3Marta Marín-Oto4Javier de Miguel-Díez5Guillermo Samuel Loscertales-Vacas6José María Tordera-Mora7Álvaro Hurtado-Fuentes8Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; Corresponding author.Department of Respiratory Medicine, Albacete University Hospital Complex, Albacete, SpainPneumology Department, Lucus Augusti University Hospital, Lugo, SpainChronic Bronchial Infection Unit, Pneumology Service, Ramón y Cajal Hospital, Alcalá de Henares University, Madrid, SpainPulmonary Division, Hospital Clínico Universitario Lozano Blesa, University of Zaragoza, Zaragoza, SpainRespiratory Care Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainPneumology Department, Hospital Universitario San Pedro, Logroño, SpainPneumology Department, Manises Hospital, Valencia, SpainPneumology Department, Hellín Hospital, Albacete, SpainPrevention 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. Resumen: La prevención de las exacerbaciones es un objetivo clave en el tratamiento de la enfermedad pulmonar obstructiva crónica (EPOC). Los efectos adversos de una exacerbación incluyen un impacto negativo en la calidad de vida y los síntomas del paciente, un deterioro acelerado de la función pulmonar, un mayor riesgo de ingresos hospitalarios y un aumento de la mortalidad. Las guías de práctica clínica relacionadas con el tratamiento de la EPOC recomiendan el cese tabáquico y la terapia broncodilatadora con o sin corticosteroides inhalados como tratamiento base para estos pacientes. Aparte de los tratamientos mencionados, existen otras terapias potenciales, como son los agentes mucolíticos, los antibióticos (orales o inhalados), los inhibidores de la fosfodiesterasa-4 o la vacunación, entre otros, que han demostrado su papel en la prevención de las agudizaciones. En esta breve revisión narrativa examinaremos la eficacia de estos tratamientos más allá del uso de la terapia broncodilatadora y los corticosteroides inhalados.http://www.sciencedirect.com/science/article/pii/S2659663625000426EPOCExacerbacionesMucolíticosAntibióticos nebulizadosProbióticosBiológicos
spellingShingle Juan Marco Figueira-Gonçalves
Francisco Javier Callejas-González
Rafael Golpe
Luis Máiz-Carro
Marta Marín-Oto
Javier de Miguel-Díez
Guillermo Samuel Loscertales-Vacas
José María Tordera-Mora
Álvaro Hurtado-Fuentes
Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids
Open Respiratory Archives
EPOC
Exacerbaciones
Mucolíticos
Antibióticos nebulizados
Probióticos
Biológicos
title Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids
title_full Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids
title_fullStr Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids
title_full_unstemmed Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids
title_short Current Evidence on the Usefulness of Potential Therapies in the Prevention of COPD Exacerbations: Beyond the Use of Bronchodilator Therapy and Inhaled Corticosteroids
title_sort current evidence on the usefulness of potential therapies in the prevention of copd exacerbations beyond the use of bronchodilator therapy and inhaled corticosteroids
topic EPOC
Exacerbaciones
Mucolíticos
Antibióticos nebulizados
Probióticos
Biológicos
url http://www.sciencedirect.com/science/article/pii/S2659663625000426
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