Combination therapy for airflow limitation in COPD

Existing evidence confirms that no pharmacologic agent ameliorates the decline in the lung function or changes the prognosis of chronic obstructive pulmonary disease (COPD). We tried a critical combination therapy for management of COPD.Current or past smoker (passive or active) COPD patients with moderate to severe COPD who did not respond to primitive therapy (i.e., oral prednisolone (50 mg in the morning) for 5 days; with Beclomethasone Fort (3 puff q12h, totally 1500 micrograms/day), Salmeterol (2 puffs q12h, 50 micrograms/puff) and ipratropium bromide (4 puffs q8h) for two months, enrolled to study. Furthermore they were received N-Acetylcysteine (1200 mg/daily), Azithromycin (tablet 250 mg/every other day) and Theophylline (100 mg BD).The study group consisted of 44 men and 4 women, with a mean age and standard deviation of 63.6？±？12.7 years (range 22–86 years). Thirteen of 48 patients (27.0%) was responder based on 15% increasing in FEV 1 (27.7？±？7.9) after 6.7？±？6.1 months (57.9？±？12.9 year old). There were statistically significant differences in age and smoking between responders and non-responders (P value was 0.05 and 0.04 respectively). There was no difference in emphysema and air trapping between two groups (p？=？0.13).Interestingly considerable proportion of patients with COPD can be reversible using combination drug therapy and patients will greatly benefit from different and synergic action of the drugs. The treatment was more effective in younger patients who smoke less.Worldwide, Chronic obstructive pulmonary disease (COPD) is the sixth leading cause of death [1] and is the only condition in the top 10 causes of death with an increasing prevalence and mortality [2]. It has been estimated that COPD will become the third leading cause of death worldwide by 2020, and its ranking relative for number of disability-adjusted life-years lost will increase from 12th to 5th [3]. COPD is characterised by slowly progressive development of airflow limitation th