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Die chronisch-obstruktive Lungenerkrankung (COPD)

Aktuelle Konzepte und neue Therapieoptionen

Chronic obstructive pulmonary disease (COPD)

Current concepts and new therapeutic options

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Zusammenfassung

Die chronisch-obstruktive Lungenerkrankung (COPD) ist eine sehr häufige chronische Erkrankung mit steigender Prävalenz. Eine Exposition gegenüber inhalativen Noxen, v. a. Tabakrauch, führt zu einer chronischen Entzündungsreaktion in den Atemwegen, begleitet von einer nicht voll reversiblen obstruktiven Ventilationsstörung. Die Zerstörung von Lungengewebe und damit eine Einschränkung des Gasaustauschs können folgen. Parallel wird eine Reihe von Komorbiditäten beobachtet. Die überarbeitete COPD-Klassifizierung berücksichtigt neben der Lungenfunktion auch Symptome und die anamnestische Häufigkeit von Exazerbationen. Kürzlich wurden mehrere neue lang wirkende Bronchodilatatoren für die Behandlung der COPD zugelassen. Kombinationspräparate, bestehend aus lang wirkenden β2-Sympathomimetika und Anticholinergika, sowie eine neue Kombination aus einem inhalierbaren Steroid und einem lang wirkenden β-2-Mimetikum werden folgen. Auch der Rauchentwöhnung kommt eine entscheidende Bedeutung zu.

Abstract

Chronic obstructive pulmonary disease (COPD) is a very common chronic disease with increasing prevalence. Inhaled particles and gases (in particular tobacco smoke) induce chronic inflammation of the airways accompanied by a not fully reversible airflow limitation. Destruction of lung tissue and deterioration of gas exchange may follow. In parallel, several comorbidites can be observed. The COPD assessment was revised and now takes into account lung function, the patients’ symptoms, and history of exacerbations. More recently, several new long-acting bronchodilators received approval. Combination products, consisting of long-acting β2-agonists and long-acting anticholinergics, and a new combination of a long-acting β-agonist and an inhaled corticosteroid will follow in the near future. Smoking cessation is of central importance.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Klemmer, T. Greulich, A.R. Koczulla und C.F. Vogelmeier geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland

    A. Klemmer, T. Greulich, A.R. Koczulla & C.F. Vogelmeier

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  1. A. Klemmer
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  2. T. Greulich
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  3. A.R. Koczulla
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  4. C.F. Vogelmeier
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Correspondence to A. Klemmer.

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Klemmer, A., Greulich, T., Koczulla, A. et al. Die chronisch-obstruktive Lungenerkrankung (COPD). Internist 55, 401–414 (2014). https://doi.org/10.1007/s00108-013-3406-5

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