Table 4.

Effects of smoking cessation, exercise and various pharmacotherapies in the treatment of chronic obstructive pulmonary disease (COPD)

	Smoking cessation	Exercise	Short-acting bronchodilator (β2-agonist or anticholinergic)	Long-acting β2-agonist	Long-acting anticholinergic	Addition of inhaled glucocorticoid in severe COPD1	Roflumilast in severe COPD
Symptoms	+	+	+	+	+	(+)	−
Obstruction	+	−	+	+	+	(+)	(+)
Exacerbations	+	+	−	+	+	+	+
Disease progression (annual FEV1 decline)	+	?	−	−	−	(+)	?
Mortality	+	+	−	−	−	(+)	?

+: definite beneficial effect; (+): small or possible beneficial effect; −: no effect; ?: no evidence.

¹In practice means terminating long-acting β₂-agonist and prescribing a combination product containing both inhaled glucocorticoid and long-acting β₂-agonist.