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Table 3 Potential new medical treatments for COPD, their mechanisms of action and reported clinical effects

From: Chronic obstructive pulmonary disease: towards pharmacogenetics

Treatment

Mechanism

Clinical effects

Genes associated with response to therapy*

Genes associated with COPD†

References‡

Cilomilast

PDE4 inhibitor

Improvement in FEV1 and quality of life; reduced FEV1 decline; fewer exacerbations

-

PDE4

[72, 73, 75]

Roflumilast

PDE4 inhibitor

Improvement in FEV1

-

PDE4

[74]

BAYx1005

LTB4 synthesis inhibitor

Reduced bronchial inflammation

-

-

[111]

ABX-IL8

Monoclonal antibody specific to IL8

Improvement in dyspnoea and FEV1 early in treatment, but no sustained improvement in lung function by the end of the trial

-

-

[112]

N-acetylcysteine

Antioxidant

No improvement in lung function or exacerbation frequency

-

GSTP1, GSTM1, EPHX1, SOD3 and HMOX1

[113]

Infliximab

Anti-TNFα

No benefit except in cachectic participants, whose 6MWT distance and frequency of hospital admissions improved

TNFA

TNFA

[53, 79]

Marimastat

MMP inhibitor

Tested in asthma; reduced airway hyper-responsiveness

-

MMP1 and MMP9

[114]

All-trans-retinoic acid

Repairs elastase/smoke induced lung damage

Clinical trials in progress; confirm safety pilot studies

-

-

[115]

Montelukast

Leukotriene receptor antagonist

Improved FEV1 and quality of life; observational study suggested reduced hospital admissions and medication usage

LTC4 synthase

-

[59, 116, 117]

  1. *Refers to all studies of the drug class, which may have been carried out on other diseases. †Refers to genes relevant to the pathways on which each listed drug acts. ‡Refers to publications reporting clinical drug trials, studies of pharmacogenetics, and those genetic association studies not listed in Table 2. Further details can be found in the text. Abbreviations: LTB4, leukotriene B4; 6MWT, 6 minute walk test.