There are plenty of treatment options for COPD (chronic obstructive pulmonary disease), a type of chronic obstructive pulmonary disease caused by a deficiency of alpha-1 antitrypsin (alpha-1), a protein that helps protect the lungs from smoke and other environmental pollutants.
Regardless of the root cause, genetic COPD behaves like other forms of the disease, causing shortness of breath, wheezing, persistent coughing, and decreased exercise tolerance. These symptoms are the goal of most COPD medications and treatments.
For the 2 to 3 percent of people with COPD who have alpha-1 deficiency, intensive therapy can do more than other treatments to relieve symptoms. According to Luis Javier Peña-Hernández, MD, a pulmonary health and sleep disorder specialist in Palm Beach County, Florida, it can even help stop the disease from getting worse.
What is augmentation therapy?
Simply put, intensive treatment for genetic COPD replaces the deficient alpha-1 protein in the blood, according to Mandy De Vries, MD, a respiratory therapist and director of education for the American Association for Respiratory Care (AARC). In this way, it helps “protect the lungs from further damage from inflammation caused by a deficiency of this protein,” she explains.
The replacement protein is derived from blood plasma from a human donor and given intravenously, which means it’s slowly infused into the bloodstream via a needle inserted into a vein, according to Mike Hess, an AARC member, respiratory therapist and pulmonary function technologist.
Intensive therapy is given once a week either in the doctor’s office or at an injection center. De Vries says some people learn to treat themselves at home. Typical sessions last about 30 minutes, and side effects are mild and temporary in most cases. They include fatigue, headache, and flu-like symptoms, which usually go away within 24 to 48 hours. (If they don’t, or become severe, it’s important to seek medical attention.)
Is intensive therapy right for you?
To be a candidate for consolidation therapy, you must meet a few criteria:
- low levels of alpha-1 (usually less than 35% of the average level of normal), which can be measured by a blood test at your doctor’s office
- Symptoms of emphysema (a type of chronic obstructive pulmonary disease that involves long-term lung damage), determined by a lung function test administered by a respiratory therapist that shows whether you are delivering enough oxygen into your blood when you breathe
- No signs of severe lung disease, such as clubbing (swelling of the fingers)
For people with certain medical conditions, such as immunoglobulin A deficiency, intensive therapy may not be recommended, according to Hess. Because of the non-alpha-1 proteins found in the infusion, some people may experience an allergic reaction, which can be mild and include hives, itching, chest tightness, or wheezing.
If you and your doctor decide that intensive therapy is right for you, you’ll also want to be comfortable sticking to it long-term, because you’ll likely have weekly infusions for the rest of your life. But, de Vries says, depending on your response to intensive treatment, your healthcare provider may adjust the frequency and dose of treatment.
Otherwise, intensive treatment shouldn’t interrupt your life too much. “With an intravenous injection, you can otherwise continue your normal daily activities,” says de Vries.
