Table 3

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

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]

*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.

Wood et al. Genome Medicine 2009 1:112   doi:10.1186/gm112