There’s no cure for COPD, but treatments like medication, inhalers, and lifestyle changes can help. Experts are also looking into new treatment options like biologic medication and stem cell therapy.
More than 11.7 million Americans have COPD — but estimates suggest millions may be undiagnosed.
COPD can seriously affect your daily life, and managing the condition can be difficult. You might have difficulty breathing, tightness in your chest, wheezing, and chronic coughing.
Luckily, your doctor can prescribe medications and lifestyle changes that can help manage your symptoms. Read on to learn more about existing and new treatment options for COPD.
There’s no cure for COPD, but treatment for the condition can help you manage it and live a long life.
Treatment for COPD differs from person to person, and they may change over time as symptoms shift. Your doctor will probably recommend a combination of medications and lifestyle changes.
Quitting smoking
Although the condition can occur for other reasons, about 75% of all COPD cases happen as a result of smoking. So, if you smoke, the first thing to do is try to quit.
While quitting may be hard, you can find support in this process through the American Lung Association, smokefree.gov, and resources in your local community.
Inhalers
Your doctor may also prescribe a bronchodilator. These medications relax the muscles around your airways to relieve symptoms. Some inhalers are long-acting, while others are short-acting.
Short-acting bronchodilators
Short-acting bronchodilators, sometimes called rescue inhalers, are not meant to be used every day. You use them as needed for quick relief when you’re having difficulty breathing.
Some of these types of bronchodilators
- albuterol (Ventolin HFA)
- metaproterenol (Alupent)
- levalbuterol (Xopenex)
An anticholinergic inhaler is another type of bronchodilator for the treatment of COPD. It helps prevent muscle tightening around the airways, too. It’s available as a metered-dose inhaler and in liquid form for nebulizers.
Ipratropium is a short-acting anticholinergic bronchodilator.
Long-acting bronchodilators
A doctor may recommend a long-acting bronchodilator if you have both COPD and asthma.
People use long-acting bronchodilators for daily maintenance therapy to control symptoms. These medications relieve symptoms by relaxing muscles in the airways to make breathing easier. They can also reduce the amount of mucus in your lungs.
Some long-acting bronchodilators include:
- salmeterol (Serevent Diskus)
- formoterol (Perforomist)
- vilanterol (Breo Ellipta)
- olodaterol (Striverdi Respimat)
There are three
- tiotropium (Spiriva)
- aclidinium (Tudorza)
- umeclidinium (available in combination)
Indacaterol (Arcapta Neohaler) is a newer long-acting bronchodilator that was approved in 2011. You should take it once a day.
This medication works by stimulating an enzyme that helps muscle cells in your lungs relax. It starts working quickly, and it can give long-lasting relief.
Combination inhalers
Steroids can also reduce airway inflammation. For this reason, some people with COPD use a bronchodilator inhaler
However, keeping up with two inhalers can feel like an inconvenience — which is why combination inhalers are a good option. These typically include a bronchodilator and a steroid.
Other types of combination inhalers exist, too. For example, some combine the medication of short-acting bronchodilators with anticholinergic inhalers or long-acting bronchodilators with anticholinergic inhalers.
There’s also a triple inhaled therapy for COPD that combines three long-acting COPD medications. The first approved triple inhaled therapy for COPD was called fluticasone / umeclidinium / vilanterol (Trelegy Ellipta).
In 2020, the FDA approved a second: budesonide/glycopyrrolate/formoterol fumarate (Breztri Aerosphere).
Oxygen therapy
COPD can cause low oxygen levels. This can make you feel dizzy, confused, and fatigued. Oxygen therapy may be able to reverse some of these effects of COPD.
During oxygen therapy, oxygen is pumped through nasal prongs or a mask directly into your nose or mouth. This direct delivery can help increase your oxygen levels.
However, oxygen therapy may not be needed all the time. In fact, some people may only need to use it as symptoms flare. Oxygen therapy can help you perform daily tasks, protect your heart and lungs from damage, and improve alertness.
Oral medications
Roflumilast (Daliresp) helps decrease airway inflammation in people with severe COPD. This medication can also counteract tissue damage, gradually improving lung function.
Roflumilast is specifically for people who have a history of severe COPD flare-ups, so it’s not for everyone.
Side effects that can occur with include:
- diarrhea
- nausea
- back pain
- dizziness
- decreased appetite
- headache
Some antibiotics and antivirals are also used to treat symptoms of COPD, especially when there is a flare-up. While these medications do not work to repair damage from the disease, they aim to stop additional damage.
Surgery
Surgery is typically a last resort as a COPD treatment. It’s usually reserved for people who do not experience relief from other forms of treatment or for people who have severe, advanced COPD.
Bullectomy
COPD can destroy the air sacs in your lungs. This causes large spaces of air, called bullae, to develop.
As these air spaces get bigger, they crowd out better-functioning areas of the lungs. This can make breathing shallow and difficult.
A bullectomy is a surgical procedure that removes damaged air sacs. It can reduce breathlessness and improve your lung function.
Lung volume reduction surgery
COPD causes lung damage, and this can make it harder to breathe. According to the American Lung Association, a lung volume reduction surgery removes about 30% of damaged or diseased lung tissue.
With damaged portions removed, your diaphragm can work more efficiently, allowing you to breathe easier.
This type of surgery is only an option for patients who have emphysema, a form of COPD that affects the upper portion of the lungs.
A new version of this surgery called robotic lung volume reduction surgery aims to achieve the same results but with a less invasive procedure. This can help reduce the risk of infection and complications. It can also speed up recovery time.
Endobronchial valve surgery
This procedure is used to treat people with severe emphysema.
With endobronchial valve surgery, the surgeon places tiny Zephyr valves in the airways to block off damaged parts of the lungs. This reduces hyperinflation, allowing healthier sections of your lungs to work more efficiently.
Valve surgery also reduces pressure on the diaphragm and lessens breathlessness. The FDA approved the use of Zephyr valves in 2018.
Lung transplant
Some people with severe COPD eventually need a lung transplant. This procedure is necessary when breathing difficulties become life threatening.
A lung transplant removes a damaged lung and replaces it with a healthy donor lung. However, there is the risk of organ rejection, and most people will need to take immune-suppressing medications daily.
Pulmonary rehab
People living with COPD can benefit from a variety of treatment strategies. This includes a treatment plan that addresses lifestyle elements like exercise, nutrition, and wellness. Pulmonary rehab seeks to do just that.
This approach combines:
- education
- exercise training
- nutrition counseling
- wellness planning
A team of doctors, nurses, respiratory and physical therapists, dietitians, and exercise specialists will work with you to address topics like:
- exercise
- nutrition
- breathing exercises
- relaxation
- emotional support
- medication information
Doctors and researchers are continually working to develop new medications and procedures to improve breathing for those living with COPD.
Biologics and IL-5 medications
COPD can result from several different mechanisms. Newer treatments aim to target those specific causes in order to eliminate them and stop inflammation.
These newer treatments are medications
For example, some people with COPD have a large number of eosinophils, a specific type of white blood cell. A drug called anti-interleukin-5 (IL-5) targets airway inflammation caused by eosinophils. This drug lowers the number of blood eosinophils, helping to reduce COPD symptoms.
More research is needed, however. Currently, some IL-5 drugs are approved for the treatment of severe asthma, but none are approved to treat COPD.
Stem cell therapy
Clinical trials are also evaluating the use of stem cell therapy for COPD.
Stem cells are undifferentiated cells that are fed into the body. This means they don’t have one job. Once they’re injected, they then become specialized to a specific need — in this case, regenerating lung tissue and reversing damage.
Researchers believe stem cells could be used to create new alveolar cells. These are the cells that are responsible for the exchange of air and gasses in the lungs.
The FDA has approved stem cell therapy for COPD in human clinical trials, but it’s
COPD can range from mild to severe. Your treatment will depend on the severity of your symptoms. If traditional or first-line therapy does not improve your COPD, speak with your doctor. You may be a candidate for an add-on therapy or newer treatments.