COPD: Die „Aschenputtel-Krankheit”? - Epidemiologie, neue Pharmakotherapie und die Konsequenzen

Zusammenfassung

Die chronisch obstruktive Lungenerkrankung (COPD) ist eine häufig zu spät oder gar nicht erkannte Erkrankung mit steigender Prävalenz. Sie verursacht eine Reihe von Symptomen, welche die Lebensqualität nachhaltig und zum Teil irreversibel einschränken. Zudem ist die COPD eine der häufigsten Todesursachen. Die Primärprävention in der westlichen Welt besteht in der Vermeidung des Zigarettenrauchens. Auch bei manifester Erkrankung kann der Patient durch den Verzicht auf das Rauchen eine gewisse Besserung der Lungenfunktionseinschränkung und des Lungenfuktionsabfalls erreichen. Eine moderne, bronchodilatierende und antientzündliche Inhalationstherapie kann nach neuesten Untersuchungen nicht nur die Lungenfunktion bei dieser Erkrankung signifikant verbessern, sondern auch die Exazerbationshäufigkeit senken. Die Vielzahl der medikamentösen und nichtmedikamentösen Maßnahmen zur Behandlung dieser bislang als irreversibel und therapierefraktär eingeschätzten Erkrankung dokumentiert den Paradigmenwandel in der Wahrnehmung und prognostischen Einschätzung dieser wichtigen Volkskrankheit.

Summary

Chronic obstructive pulmonary disease, the prevalence of which is on the increase, is often diagnosed too late, or not at all. It is associated with a range of symptoms that have a restricting effect - which is long-lasting and sometimes irreversible - on the quality of life of the patient. In addition, COPD is one of the most common causes of death. The primary preventive measure in the West is abstinence from smoking. Even patients with manifest disease can experience a certain improvement in their diminished pulmonary function by giving up smoking. According to the latest investigations, modern bronchodilatory and anti-inflammatory inhalation treatment cannot only significantly improve lung function in this condition, but can also decrease the incidence of exacerbations. The numerous medical and non-medical therapeutic options that can be applied to this disease, previously considered irreversible and refractory to treatment, documents the paradigm change in the perception and prognostic evaluation of this major widespread disease.

Key Words

chronic obstructive pulmonary disease - long-term treatment - long acting beta-2 agonists - inhalative glucocorticosteroids - long-acting anticholingergics - theophylline - oxygen therapy - ventilation

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1 copenhagen city lung study

2 european respiratory society study on chronic obstructive pulmonary disease

3 inhaled steroids in obstructive pulmonary disease

4 lung health study

5 global initiative for chronic obstructive lung disease

6 trial of inhaled steroids and long-acting beta-2-agonists

Anschrift des Verfassers