What is the only therapy that may alter the course of Chronic Obstructive Pulmonary Disease (COPD)?

Supplemental oxygen is crucial in managing Chronic Obstructive Pulmonary Disease (COPD), particularly for patients who demonstrate significant hypoxemia. While many therapies like inhaled steroids, bronchodilators, and antibiotics can alleviate symptoms or manage exacerbations, they do not modify the progressive nature of the disease itself.

The main goal of supplemental oxygen therapy is to maintain adequate oxygen saturation levels, thus potentially preventing complications associated with severe hypoxemia, such as pulmonary hypertension and right-sided heart failure. Prolonged use of supplemental oxygen has been shown to improve survival rates in patients with advanced COPD who experience chronic low oxygen levels, thereby altering the disease's course.

In contrast, inhaled steroids primarily reduce inflammation but do not significantly change the underlying trajectory of disease progression. Bronchodilators can improve airflow and help with symptom control but do not address the chronic nature of the lung disease itself. Antibiotics are effective in managing exacerbations caused by respiratory infections, but they do not modify the long-term course of COPD. Therefore, oxygen therapy stands out as the only treatment with evidence of altering the natural history of the disease.