Recent advance in inhaler medications for chronic obstructive pulmonary disease patients

Chronic obstructive pulmonary disease (COPD) is one of the highest ranking diseases with regard to prevalence and mortality in Korea and also worldwide. In the past decade, effective inhaler medications for COPD treatment have been developed or approved. These inhaler medications have been proven to have beneficial effects on symptoms, lung function, quality of life, exercise capacity, and exacerbation. The inhalers used widely are long-acting anticholinergics, long-acting beta2-agonists, and combined inhalers of a corticosteroid and long-acting beta2-agonist. These inhaler medications are more effective than oral medications and less likely to produce adverse events. However, the inhaler medications should be used appropriately to achieve the desired effect. For COPD patients with a forced expiratory volume in 1 second (FEV1) less than 80% of the predicted value, a long-acting anticholinergic or long-acting beta2-agonist is usually the medication of first choice. If a COPD patient with a FEV1 less than 60% of the predicted value suffers frequent exacerbations, a combined inhaler of corticosteroid and long-acting beta2-agonist is a good choice. To prescribe an inhaler medication for COPD patients, spirometry should be performed, not only to confirm the diagnosis but also to define severity. These effective inhaler medications should be used widely for COPD patients in Korea.