COPD

COPD guidelines updated


New therapies for the management of COPD are a focus of the latest update to the internationally recognised COPD-X Plan.

These include two new combination therapies and a new LAMA medicine device. The guidelines also provide updates on the safety, efficacy and risks of some combinations, and updates on the endobronchial valves and coils, and the use of emphysematous lung sealant.

Lung Foundation Australia announced the recent update to The COPD-X Plan: Australian and New Zealand Guidelines for the Management of COPD after an extensive review of the published evidence in COPD up to December 2015.

Dr Eli Dabscheck, COPD-X Guidelines Committee Deputy Chair and Staff Specialist in the Department of Allergy, Immunology and Respiratory Medicine at The Alfred Hospital in Melbourne, said it was important for physicians to remain up to date with the guidelines.

“Over the last few years we have seen the advent of many new therapies for COPD which only highlights the need for health professionals to be across the evidence to ensure effective management of their patients,” he said.

He also cautioned that the raft of new therapies should not automatically be seen as replacements for existing therapies. He told the limbic that while the new therapies offered more treatment choices, existing therapies were still important.

“Just because they’re new or long-acting doesn’t mean they’re superior to existing products,” he said. “COPD management should be based on what’s going to help the patient.”

Another important addition to the guidelines was addition of evidence that showed “bundling” non-pharmacological interventions such as smoking cessation counselling, screening for GORD, and standardised inhaler education had no benefit to readmission rates when they did not include pulmonary rehabilitation.

Dr Dabscheck said there was growing evidence supporting pulmonary rehabilitation as a key component, and there was scope to use telehealth to improve access to patients.

Surgical techniques such as endobronchial valves, coils and emphysematous lung sealant were also discussed in the guidelines update, and Dr Dabscheck is particularly interested in the latest evidence for endobronchial coils.

“It’s a therapy that holds promise and I’m looking forward to seeing more data,” he said.

Other highlights included new information about the efficacy and safety of the umeclidinium/vilanterol combination and discussion of the increased risk of pneumonia with the fluticasone furoate/vilanterol combination.

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