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Controversias en el tratamiento de la enfermedad pulmonar obstructiva crónica

Klaus F Rabe¹, Jadwiga A Wedzicha

¹Christian Albrechts University Kiel, Germany. k.f.rabe@kh-grosshansdorf.de

Lancet (London, England)

|September 13, 2011

Resumen

El manejo de la enfermedad pulmonar obstructiva crónica (EPOC) implica debates en curso sobre la intervención temprana, el uso de corticosteroides inhalados y los antibióticos a largo plazo. Las terapias novedosas son cruciales para las exacerbaciones agudas y el tratamiento personalizado basado en los fenotipos de EPOC.

Área de la Ciencia:

Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
Investigación de las vías respiratorias.

Sus antecedentes:

La enfermedad pulmonar obstructiva crónica (EPOC) presenta una morbilidad y mortalidad significativas.
El manejo actual de la EPOC se enfrenta a varias controversias sin resolver a pesar de la creciente evidencia.
Es posible que los criterios espirométricos existentes para el diagnóstico de la EPOC no reflejen completamente la gravedad o la comorbilidad de la enfermedad.

Objetivo del estudio:

Para resaltar las controversias existentes en el manejo de la EPOC.
Para enfatizar la necesidad de mejores métodos de diagnóstico más allá de la espirometría.
Discutir las estrategias terapéuticas emergentes y el papel del fenotipo en la EPOC.

Principales métodos:

Revisión de la literatura sobre las directrices actuales de manejo de la EPOC y la investigación.
Análisis de las controversias que rodean la intervención temprana, los corticosteroides inhalados y el uso de antibióticos.
Discusión de nuevos objetivos terapéuticos y la importancia de los fenotipos de la EPOC.

Principales resultados:

Significativos debates persisten con respecto al momento óptimo de las intervenciones y la eficacia de los corticosteroides inhalados.
El uso a largo plazo de antibióticos para la prevención de la exacerbación está recuperando la atención.
Existe una necesidad crítica de nuevos medicamentos para manejar eficazmente las exacerbaciones agudas de la EPOC.

Conclusiones:

El manejo de la EPOC requiere abordar las limitaciones diagnósticas y las incertidumbres terapéuticas.
Las estrategias de tratamiento personalizadas guiadas por distintos fenotipos de EPOC son esenciales para la atención futura.
La investigación adicional en nuevas terapias y herramientas de diagnóstico es imperativa para mejorar los resultados de los pacientes.

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