Exacerbations drive morbidity, mortality, and the costs of care in patients with chronic obstructive pulmonary disease (COPD). Inhaled therapy with long-acting bronchodilators, with or without inhaled glucocorticoids, can help prevent further exacerbations, but some patients continue to experience them despite optimal inhaled medical therapy. These patients are most prone to hospitalization and death with limited pharmacological alternatives to decrease future exacerbations. Long-term macrolide therapy and phosphodiesterase type 4 inhibitors may be options for some patients with recurrent exacerbations, but use of these agents can be cost prohibitive, or cannot be tolerated by all patients. This population represents a large clinical unmet need that requires additional therapeutic options.
Criner GJ, Celli BR. Failure of Low-Dose Theophylline to Prevent Exacerbations in Patients With COPD. JAMA. 2018;320(15):1541–1542. doi:10.1001/jama.2018.14295
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