Abstract
The goal of pharmacologic therapy of stable chronic obstructive pulmonary disease
(COPD) is to reduce symptoms, improve exercise intolerance and health-related quality
of life, and to reduce exacerbations. Inhaled long-acting β2-agonists (LABAs) and
long-acting muscarinic antagonists (LAMAs) are equally effective for the symptomatic
management of COPD. However, LAMAs are more effective than LABAs in the reduction
of exacerbations. In patients with symptomatic COPD pharmacologic therapy is usually
escalated using the fixed combination of LAMAs and LABAs (dual bronchodilation), which
is also superior to LAMA monotherapy in the prevention of exacerbations. Adding inhaled
corticosteroids (ICS) to LABA and LAMA (triple therapy) for a prevention of exacerbations
results in a further reduction of exacerbations, especially in those patients with
higher blood eosinophil counts. Non-pharmacologic management of COPD patients includes
smoking cessation programs, vaccination, pulmonary rehabilitation, and strategies
to improve or maintain their physical activity.
Das Ziel der medikamentösen Dauertherapie der chronisch obstruktiven Lungenerkrankung
(COPD) ist, die Symptome zu lindern – einschließlich Verbesserung der Belastbarkeit
und Lebensqualität – sowie Exazerbationen zu verhindern. Dieser Beitrag erläutert
die Stufentherapie der COPD anhand der kürzlich publizierten deutschen Leitlinie zur
COPD [1]. Diese orientiert sich wiederum an den Empfehlungen der internationalen GOLD-Initiative
[2].
Schlüsselwörter
chronisch obstruktive Bronchitis - Lungenemphysem - medikamentöse Behandlung - nicht
medikamentöse Behandlung
Key words
chronic obstructive pulmonary disease - pharmacologic therapy - non-pharmacologic
therapy
