Management of chronic obstructive pulmonary disease: An emphasis on recently approved medications and products in the pipeline. (cover story)

ADRENOCORTICAL hormones; HORMONE therapy; HYDROCARBONS; OBSTRUCTIVE lung disease diagnosis; OBSTRUCTIVE lung disease treatment; THEOPHYLLINE; CELL receptors; BRONCHODILATOR agents; PHOSPHODIESTERASE inhibitors; MUSCARINIC antagonists; AEROSOL therapy; OBSTRUCTIVE lung diseases; HEALTH outcome assessment; EXPERIMENTAL therapeutics; DRUG development; TREATMENT effectiveness; THERAPEUTICS

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is characterized by chronic and progressive airflow limitation associated with chronic exposure to noxious particles and/or gases. COPD is the third leading cause of death in the United States, affecting approximately 13.1 million individuals. In 2010, direct healthcare expenditures were projected to be $29.5 billion with an additional $20.4 billion in indirect costs. Pharmacologic treatment has not been shown to consistently improve survival or slow the progressive decline in lung function. Instead, the focus has been to control symptoms, reduce exacerbations, increase exercise tolerance, and improve quality of life. A number of novel ultra-long-acting bronchodilators with once-daily dosing are in advanced development and show promise based on results from clinical trials. This article provides an overview of COPD and reviews available and emerging agents. [ABSTRACT FROM AUTHOR]