Pulmonary medicine has seen a dramatic change in the way we treat almost every respiratory disease. I have been at this for a long time and for decades the basic treatments revolved around medications that differed in name only. They contained molecules that had similar effects and often did not offer any greater patient improvement.
Enter the biologics. These are medications that I have spoken about in other articles, and their use continues to advance. Biologics are medications, usually injectables, that attack some part of our immune system. These medications have been directed at diseases such as asthma, fibrosis and cancer. Recently, it has been demonstrated that some of the biologics that we have been using in patients with asthma have a positive effect in patients with COPD if they have the appropriated blood tests that identify their immune systems as susceptible to their effects.
Although preliminary studies suggest benefit in some patients I really think it is too early to determine how most patients will respond. Researchers are also looking at other immune pathways to attack as we find out more and more about the basic inflammatory process that underlies COPD.
Lastly, and not surprisingly, is the cost of these therapies. They need to have significant benefit to justify their expensive cost, not just to the patient but to the health care system overall. In the meantime, if you have COPD and still smoke, data shows that smoking reduces the effectiveness of most current therapies.
