Pharmacotherapy of chronic obstructive pulmonary disease: how to make a choice?


A.G. Romanovskikh (1), Yu.G. Belotserkovskaya (1), I.P. Smirnov (1), S.N. Shvaiko (2)

1) Russian Medical Academy of Continuous Professional Education, Moscow; 2) S.P. Botkin City Clinical Hospital, Moscow
The practical choice of the optimal pharmacotherapeutic strategy for chronic obstructive pulmonary disease (COPD) is often quite complicated. To make a decision about the need to change the volume of therapy, a new concept for controlling COPD can be useful, providing a dynamic assessment of the severity of symptoms, and the frequency and severity of exacerbations as indicators of the stability of the disease as a result of treatment. This article discusses clinical examples of managing patients with inadequate control of COPD. It is emphasized that the priority pharmacotherapeutic strategy for COPD is the use of long-acting bronchodilators, primarily fixed combinations of long-acting β2-adrenoagonists and long-acting anticholinergics that provide optimal control of symptoms and reduce the frequency of exacerbations of the disease in the main patient population. With repeated exacerbations of COPD on the background of bronchodilator therapy, however, the inclusion of inhaled glucocorticosteroids in the treatment program of the disease should be considered.
Keywords: chronic obstructive pulmonary disease (COPD), pharmacotherapy of COPD, control of COPD, vilanterol/umeclidinium, vilanterol/fluticasone furoate

About the Autors

Corresponding author: Anna G. Romanovskikh, PhD, Associate Professor at the Department of Pulmonology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; e-mail:
Address: 2/1, build. 1, Barrikadnaya Street, Moscow 123995, Russian Federation

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