As the holidays approach, COPD patients face an increased risk of exacerbations due to seasonal stress and winter illnesses. In his recent Virtual Hallway lecture, respirologist Dr. Pierre Landry shared strategies for preventing these flares and optimizing treatment, including the advantages of single inhaler triple therapy (SITT). Here’s a quick dive into his clinical insights.
Each COPD exacerbation causes a loss of lung function, pushing patients further from their baseline. Older adults often fare worse, with hospital stays leading to rapid deconditioning. Avoiding these exacerbations isn’t just about lung health—it’s about preserving quality of life.
For prevention, nothing tops smoking cessation. Dr. Landry recommends a mix of pharmacologic aids, such as nicotine replacement and varenicline, to support patients ready to quit. He also emphasizes the benefits of pulmonary rehabilitation, though access remains limited.
Single inhaler triple therapy (SITT) combines a LAMA, LABA, and ICS in one device. SITT’s simplicity increases patient adherence and reduces exacerbations by up to 33% compared to multiple inhalers. Dr. Landry is clear: for patients struggling with adherence or facing frequent exacerbations, SITT can simplify management and improve outcomes.
Vaccinations are another key. Dr. Landry advocates annual flu and COVID-19 shots, as well as pneumococcal and RSV vaccines, to guard against infections that worsen COPD. Prevention here means fewer exacerbations and safer winters.
When inhaled therapies fall short, Dr. Landry turns to oral treatments like azithromycin and N-acetylcysteine (NAC) to control inflammation and mucus. These additions, especially in non-smokers, can make a critical difference for those with chronic bronchitis symptoms.
While still in clinical trials for COPD in Canada, biologics like dupilumab could soon offer new options for patients with an eosinophilic phenotype. Until then, Dr. Landry advises focusing on proven treatments.
Dr. Landry’s approach to COPD management focuses on strong adherence, preventive care, and comprehensive treatment, all designed to keep patients out of hospitals and living fuller lives. Single inhaler triple therapy, combined with vaccinations and lifestyle support, can be a straightforward yet powerful approach.
Catch the full recording on the Virtual Hallway platform to get all of Dr. Landry’s practical tips on COPD management.
Disclaimer: This post shares educational insights and does not replace personalized medical advice.
