New Medications for COPD?

This article was reviewed by Senior Director of Community Engagement and COPD360social Community Manager, Bill Clark, as well as certified staff Respiratory Therapists on January 29, 2020.

Dear COPD Coach,
Why aren’t there more drugs out there for COPD? Other people with COPD that I talk with seem to all take the same medications. Also, I am always hearing about some big advances in research with other diseases, but I don’t hear much about COPD. What is going on?

Looking for Answers

Dear Looking,

This is a topic that is very much a concern for those in the COPD community. However, the answer is not really an easy one to explain, but I will try.

COPD is the fourth leading cause of death in the U.S., and unlike many of the other diseases, the numbers continue to rise. As far as new medications, much of this development depends on research. What is interesting to note is that despite this dubious distinction, COPD consistently gets the lowest levels of research funding. Simply put, without the research, cures and new treatments are slow in coming.

Even with research, drug makers must face many hurdles in order for their product to make it to market. As a part of this process, the drug companies must do extensive trials in order to establish such things as product safety, dosage, side effects, interactions with other drugs, to name a few. In order to conduct these trials, the investigators must establish a protocol and once approved must recruit a cohort, which is a group of patients who are willing to participate. Establishing a trial and recruiting a cohort can be difficult, expensive, and very time consuming. Some cohorts have taken as long as a year to recruit, and often are the biggest obstacle for drug makers to overcome.

Once the study has been completed, the findings and data are presented to the Food and Drug Administration (FDA), who reviews the material, and either approves it or recommends further testing or documentation. A public hearing is held to discuss the findings and final approval is either given or denied. It is not uncommon for the entire process to take years. Many potential drugs do not pass the trial stage! While we don’t want a dangerous drug to be rushed to market, we would certainly like to see development and approval move much more quickly!

So, the question remains, what is the answer?

In short, the responsibility lies with many.

As far as research, the government bears a great deal of responsibility. Oftentimes other diseases that affect far fewer people, receive more research dollars simply because their patients are more vocal. As far as new treatments, much of this is shouldered again by the government’s lack of providing research dollars. The pharmaceutical companies in their search for such treatments are understandably concerned with costs of development as well as potential profits. The costs involved with bringing a drug to market are staggering.

The responsibility also lies with us, the patients. For too long we have sat back and allowed events to take their own course. In short, our voices were never heard. There are things we can do to change the process and make the system work for us! What are they?

  • Join the COPD Patient-Powered Research Network, a research registry of over 75,000 individuals with COPD who have agreed to share their health information and the impact the disease has on their lives. Operated and governed by groups of patients and their partners, the information is kept in a secure database to be used for research – ultimately leading to a deeper understanding of the disease.
  • Get involved in advocacy efforts. One goal of our State Captain program is to reach out to all 435 members of the Congress to educate them on COPD and to make our views known. It requires nothing more than occasional phone calls or letter writing but can – and will – make a huge difference. You can find out more about that program here.
  • Contribute! Even a few dollars can make a huge difference in speeding up and developing cures.

You can make a difference with just a little effort!

–COPD Coach

Coaches Corner is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to The COPD Coach.


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  • Does anybody know of different kinds of drugs for COPD in more advanced countries?
  • If COPD is pretty much irreversible due for example to scarring of the airways and breakdown of the alveoli, I don't see what medication could undo that damage. As I understand it the only other possibility is some sort of surgery?
    I am currently using Atrovent and Fostair with Seebri and n-acetyl cysteine. My condition is very much affected by humidity and pollen, and on those days the medication doesn't much help due I think to the amount of scarring and inflammation.
    What do others think? Can any medication undo the physical damage to airways?
    • I took part in a pulmonary rehab class last year (which I highly recommend) which included a Q&A session with a pulmonologist. Someone in class asked him about some new COPD medications seen advertised on television recently, and whether or not, as a patient, how beneficial these "new" medications might prove to be. He told us that often what you see advertised as "new" is in fact an old medication renamed and repackaged. He said what prompts this by the manufacturers is because the patent the company has for a particular medication is about to expire. And when that happens other manufacturers can start making a generic of the same drug. And if that were to occur the drug companies would end up losing millions (billions?) of dollars in revenue. Of course, we as consumers would certainly benefit. So I wonder, what's the motivation for developing new drugs to "undo the physical damage to airways?" I personally don't believe there is any urgency to do that. Certainly not by BIG PHARMA. Because if there were such drugs, could we then stop using our Symbicort, Spiriva, etc.? Now that would be nice. But I'm not holding my breath.

    • Davidgh
      Can we respond to you? btw you're not English are you? You write like an Englishman.
    • Hi Soggybottombhoy - I attended a COPD Foundation Educational Workshop recently and learned that there are several new drugs that should be available later on this year. They are similar to Daliresp, which is a Phosphodiesterase 4 (PDE4) inhibitor, and reduces inflammation in many patients, thus reducing exacerbations. So while they and other drugs do not "undo" the physical damage, they may make life easier for some of us.
    • Davidgh,

      Im not sure the advice you got in PR is entirely accurate. There have been about 18 new respiratory drugs for COPD introduced since 2004. Most of these drugs are long acting controller agents and combo drugs. So, i would agree that there has been only one new class introduced, roflumilast over the last 13 years, but it is inaccurate to say the other drugs are just repackaged old drugs.

      The only case where this is true, is with albuterol mdi. When the FDA banned the CFC propellant and required use of HFA, this required new patents and a high price for brand name ProAir. No generics available yet.

      I also agree that there is strategy at play with introduction of new drugs and patent timing so companies protect profit, however, most of the new drugs do contain new compounds that are different from the past. Many drugs can now give 12-24 hours of relief, thereby establishing better control of symptoms with less burden in remembering to dose so frequently.

      I have been in touch with industry goals and while one may argue that there is little interest from industry in finding curative drugs since they profit so much from selling control agents, this is just naive.

      John Walsh and many others have constantly challenged pharma to explore new agents and new drug classes. Many agents, including one or more from broccoli ectract, thought to be a powerful antioxidant, are being studied.

      The fact remains that COPD is still poorly understood from a biophysical and genetic perspective. We need more studies that target the genesis of COPD before we can develop cures or even better drugs in new classes.

      As a final thought, look at cancer. There is a ton of research and new drugs coming out of this market by pharma. Many agents can cure cancer in early stages. There is no long term controller drugs. So, i can asure you that industry would be very interested in producing curative agents for COPD if they could. The first one to introduce that drug would profit immensely. So interest is there, but we just dont have the data today to understand what targets are triggering COPD. So, we must aim research at COPD genesis, first.
      I totally agree that we need more interest and money for COPD research.

  • Hi Karen. Thanks for the info. Those drugs will probably be marketed under a different name here in England, but I shall print off the names and ask my doctor about them.
    Over here our medication and treatment pretty much mirrors your own, but the difference is that you Americans are far more organised and open to alternative treatments. When I told my doctor about the benefits of n acetylcysteine for example, it met with a cool reception!
    You know that we have a State/tax funded health care system, and our medication is free if you're over 65 or have certain critical conditions?

    I haven't found a COPD blog similar to this
    • Hi Karen. Thanks for the info. Those drugs will probably be marketed under a different name here in England, but I shall print off the names and ask my doctor about them.
      Over here our medication and treatment pretty much mirrors your own, but the difference is that you Americans are far more organised and open to alternative treatments. When I told my doctor about the benefits of n acetylcysteine for example, it met with a cool reception!
      You know that we have a State/tax funded health care system, and our medication is free if you're over 65 or have certain critical conditions?

    • Hi Soggybottombhoy - from your screen name, I kind of thought you might be from England, so I'm glad I guessed correctly. The generic name for Daliresp is roflumilast, and it's been available for quite a few years in the US. (I believe it's called Daxas in the UK).

  • Hi Karen.
    Found this..
    Side effects seem a bit grim, but I could do with losing a bit of weight...
    ps my real name is John -but don't let anyone else know.. :0)
    • Hi Soggybottombhoy.
      I've been taking Daliresp (Roflumilast) for over a year now. And since taking it I haven't experienced any flareups. And the only side effect that I noticed was some gastrointestinal upset (diarrhea). The drug was designed to inhibit a protein called PDE4 which helps to reduce flareups. But after prolonged use, a study found that the drug increases a protein called PDE4B2, which increases inflammation. I told my doctor about the study I read concerning this, and asked if it would be OK if I took the drug every other day instead of everyday. I got his OK to proceed and haven't noticed any difference for the 3 months I've been skipping a dose.
  • Hi Davidgh,
    "I told my doctor about the study I read concerning this, and asked if it would be OK if I took the drug every other day instead of everyday. I got his OK to proceed and haven't noticed any difference for the 3 months I've been skipping a dose. "
    Now that's good doctoring. My doctor allows me to skip stuff just to avoid the body getting too used to a particular medication.
    I should think the majority of COPD sufferers are ex smokers. I am, but to demonstrate my stupidity further I smoked even though I was a long term asthmatic, so in certain weather conditions or various 'triggers' the asthma kicks in. But you wouldn't know it was asthma as I no longer have the lung power to wheeze properly!
    All my own fault.
    This little baby allows me to cut the grass and weeds in the ditch, or do DIY stuff around the house because it filters out dust and pollen. Unfortunately it can't reduce humidity.
    Anyway thanks for the info. I take it you're not an Englishman but your writing style is not like other Americans I have encountered.
    • Soggy, the every other day is a techniques that's often used to help people get past some of the more difficult side effects of the med; however, I would suggest that you and your doc consider upping the dose so that you're getting the full dose now that you're accustomed to it. We do know that people who stay at the half dose don't do as well as people on the full one. Just sayin'........
  • Thanks Jean. I'll find out if my doctor thinks this Roflumilast is suitable for me, and if it is I will take the full dose to start with.
  • I am on Prednisone and Advair for Emphysema. Currently I am on 5 mg. Prednisone daily and I am now on oxygen 24/7 set at 3. Last year I only needed oxygen at night set at 2. and only took Prednisone intermittently. So overall I am worse but can still function pretty well. I take vitamins, eat healthy and spend time with friends, text with my grandchildren, read, watch movies and find a reason to laugh every day. I think a positive attitude with peace and contentment make a big difference. I have not been hospitalized or had exacerbations or infections since I was diagnosed over 2 years ago. I sure wish they would advance the studies on stem cell treatments so they are a viable choice. Everyone affected by this disease should constantly be asking about it. Make everyone aware how much it is needed.
  • Hello everyone, its been a long time but a lot has been going on. I have been lucky to be accepted in a clinical trial for EVB PulmonX vale implants at UC DAVIS in Sac,ca. At first I was not sure about this or the coil implants but after reading a LOT i went and requested to join the program. Well it took some time but next thing i'm getting the implants. They placed 2 EVB valves in my upper left lobe. 2-3 hours later I experienced a pneumothorax, the worst thing that has ever happened to me. About 3-4 weeks later we are back on the table putting the EVB back in its original location. It has been 3 months and all is good for now. It has helped me breath better at sea level but not so good at 4000+ feet. We are planning a return to Washington State in 2018 at sea level were my wife will finish her Master Degree and I only hope to live lone enough to see it. As it is my lungs are sooooo bad that there is no other choice for me except the EVB valves. This is a study and someday soon I hope the FDA will allow and approve it for standard use for COPD patients. Lung Reduction and Lung Transplants are for the lucky ones that meet some very severe requirements. Myself would not survive the surgery. I go to Pulmonary rehab. It helps.I work out at home it helps but the lungs are gone and they will only worsen over time. The only thing you can do is keep the faith, never let your doctors off the hook about new treatment or medications. Remember you cannot cure it but you can slow it down. Im trying for the right side study implants but i don't think they will accept me but you can get involved thru your doctor, social worker and the internet for clinical trials in the us. Don't give up, live for today as yesterday is gone and tomorrow is not here yet. Protect yourself with whats a hand and look for things to help you along the way. Masks are great for pollution protection. Well it time for me to say by for now and wish the very best for each of you s you travel this road with so many asking the same questions and searching for cures. Stem cell is so far away from us for now but maybe someone here or Europe will get it right and we will all party.
    • Hi Kenny P - I hope that you'll continue to post and let us know how things go for you. Pulmonx is pretty close to applying to the FDA for approval for their valves, and are hoping that they will be available by 2018.

      I want to encourage everyone to join the COPD PPRN - it's a registry of COPD patients and persons at risk for COPD who are willing to be part of clinical trials and/or studies. Here's a link:

      I hope that you continue to do well - thanks for posting about your experience.
  • Would live to get a list of the major meds new and old, for a discussion with my doctor on friday -- is there such a copd meds list somewhere? thanks
    • Yes. You can download it from the Downloads Library on the COPDF site. Booklet is called "Optimal Care of COPD - Including How to Get the Most Out of Your Medications".

      Great booklet that gives analogies for how meds work. It also includes a full list of drugs organised by each class. However, these drugs are listed by trade name.

      The other resource is the Pocket Consultant Guide app. Only for apple products. The All Medications tab will list all trade name drugs, then you can toggle to generic names so you can see for dure thst the new drugs do in fact have new chemicals as I described previously.