Tailoring COPD Treatment: From Inhalers to Biologics
In the final video, PA Bizik explains inhaled therapy classes—LABAs, LAMAs, and ICS—including when each is appropriate based on GOLD guidelines and the importance of involving patients in inhaler selection. He also introduces biologics for patients with eosinophilic COPD and a history of exacerbations, highlighting how these therapies target underlying inflammation. Patient involvement in inhaler selection is shown to increase adherence and reduce errors. Additional options like PDE4 inhibitors are discussed for patients without eosinophilic profiles.
Key Takeaways:
- Initial treatment for COPD includes bronchodilators and often inhaled corticosteroids.
- If patients are still experiencing exacerbations and have elevated blood eosinophils, it is likely appropriate to add a biologic.
- Biologics have been shown to reduce exacerbations and improve lung function.
Speaker
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References and Additional Resources:
American Lung Association. Understanding Your COPD Medications. Lung.org. Accessed July 23, 2025. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/treating/copd-medications
Bafadhel M, McKenna S, Terry S, et al. Acute exacerbations of chronic obstructive pulmonary disease: Identification of biologic clusters and their biomarkers. Am J Respir Crit Care Med. 2011;184(6):662-671. doi:10.1164/rccm.201104-0597oc
Brightling CE, Monteiro W, Ward R, et al. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2000;356(9240):1480-1485. doi:10.1016/S0140-6736(00)02872-5
Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Mangement, and Prevention of Chronic Obstructive Pulmonary Disease.; 2025. https://goldcopd.org/2025-gold-report/
Inhalers. Cleveland Clinic. Accessed July 23, 2025. https://my.clevelandclinic.org/health/treatments/8694-inhalers
Pascoe S, Locantore N, Dransfield MT, Barnes NC, Pavord ID. Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. Lancet Respir Med. 2015;3(6):435-442. doi:10.1016/S2213-2600(15)00106-X
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