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COPD — zukünftige Therapieoptionen

Was können wir mittelfristig erwarten?

COPD — future treatment options

What can we expect in the medium term?

  • Leitthema
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Der Pneumologe Aims and scope

Zusammenfassung

Unter der Vorstellung, dass entzündliche Veränderungen in der Pathogenese der COPD eine wesentliche Rolle spielen, wird mit verschiedenen therapeutischen Neuentwicklungen zur Behandlung dieser Entzündung die Hoffnung verknüpft, die schlechte Prognose der COPD einerseits und die unbefriedigende Therapierbarkeit dieser Erkrankungen andererseits im Sinne einer „regenerativen Medizin“ zu verändern. Zu den Substanzen, mit denen entsprechende Erwartungen verknüpft werden und die sich gegenwärtig in klinischer oder präklinischer Entwicklung befinden, gehören neue Medikamente zur Raucherentwöhnung im Sinne einer Primärprophylaxe, darüber hinaus Phosphodiesteraseinhibitoren, Antileukotriene und Zytokinantagonisten, insbesondere TNF-α-Blocker, aber auch Inhibitoren der Neutrophilenelastase, des Nuklear-Faktors κB, Tyrosinkinaseantagonisten, Mukolytika, Chemokinantagonisten und neue Antibiotika zur Therapie der manifesten COPD. Auch wenn dieses große Arsenal an zukünftigen Therapieoptionen auf eine bessere Behandelbarkeit der COPD in ihren verschiedenen Schweregraden hoffen lässt, so ist gegenwärtig kaum abzusehen, ob und welche dieser Neuentwicklungen eines Tages zur Verfügung stehen und welchen Stellenwert sie dann besitzen.

Abstract

Chronic obstructive pulmonary diseases (COPD) will become one of the leading causes of death and one of the most common diseases in the world. Based on the assumption that inflammatory changes play a major role in the pathogenesis of COPD, several new therapeutic options are being developed which offer some hope that the dismal prognosis of COPD and its unsatisfactory response to current treatment options will be improved. Among those strategies which are linked to such expectations and which are currently being investigated in preclinical and clinical studies are new drugs for smoking cessation for primary prevention of COPD as well as phosphodiesterase inhibitors, antileukotrienes, and cytokine antagonists, especially TNF-α blockers, but also inhibitors of neutrophil elastase, nuclear factors κB, tyrosine kinase antagonists, mucolytics, chemokine antagonists, and new antibiotics for the treatment of established COPD. Although this rather large amount of compounds promises to improve treatment options and treatment results in COPD of differing severity, it is difficult to currently estimate which of these developments will arrive on the market and which role they will then play in the future therapy of COPD.

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  1. Abteilung für Pneumologie, Klinik und Poliklinik für Innere Medizin, Universität Rostock

    J. C. Virchow

  2. Abteilung für Pneumologie, Klinik für Innere Medizin, Universitätsklinikum, Ernst-Heydemann-Straße 6, 18057 , Rostock

    J. C. Virchow

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Virchow, J.C. COPD — zukünftige Therapieoptionen. Pneumologe 3, 129–139 (2006). https://doi.org/10.1007/s10405-006-0086-z

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