Remission & chronicity

Spontaneous remission

Effectively zero — airflow obstruction is irreversible by definition in COPD; FEV1 decline continues at 30-60 mL/year on standard care

Best-intervention remission

Smoking cessation slows FEV1 decline to near-normal aging rate (the only intervention that does this); lung volume reduction surgery (LVRS) improves FEV1 15-20% in selected emphysema patients; 52% of COPD patients achieve clinically meaningful improvement after pulmonary rehabilitation

Gap size

Large for disease modification (smoking cessation the only real lever); moderate for functional outcomes (pulmonary rehab underused)

Primary barrier

biological + practice

Biological limit: structural lung damage is not reversible with any current pharmacotherapy. Practice gap: pulmonary rehabilitation achieves clinically meaningful improvement in 52% of patients but fewer than 2% of eligible COPD patients in the US receive it. 26% of patients with a COPD diagnosis have no evidence of airflow obstruction on spirometry (misdiagnosed, overtreated)

Biomarker Targets & Therapeutic Agents

Gene targets queried against DGIdb, Open Targets, ChEMBL, PubMed, and Europe PMC. Agents ranked: ● Clinical > ● Mechanistic > ● Correlative.

ADRB2 335 CXCR2 207 ELANE 210 MMP12 181 MMP9 212 MUC5AC 4 NFE2L2 1025 PDE4D 184 SERPINA1 2 TGFB1 62

ADRB2

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Source
CARVEDILOL	↓ inhibits	Mechanistic	DGIdb
CHEMBL:CHEMBL1257092	? unclear	Mechanistic	DGIdb
SODIUM CHLORIDE	? unclear	Mechanistic	DGIdb
PENBUTOLOL SULFATE	↓ inhibits	Mechanistic	DGIdb
DESIPRAMINE	? unclear	Mechanistic	DGIdb
METIPRANOLOL	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL531322	? unclear	Mechanistic	DGIdb
NADOLOL	↓ inhibits	Mechanistic	DGIdb
PIRBUTEROL	? unclear	Mechanistic	DGIdb
FENOTEROL	↑ activates	Mechanistic	DGIdb
TIMOLOL	↓ inhibits	Mechanistic	DGIdb
ABEDITEROL	↑ activates	Mechanistic	DGIdb
PINDOLOL	↑ activates	Mechanistic	DGIdb
BRONCHODILATOR	? unclear	Mechanistic	DGIdb
TULOBUTEROL	↑ activates	Mechanistic	DGIdb
PHENYLEPHRINE HYDROCHLORIDE	? unclear	Mechanistic	DGIdb
GSK159802	↑ activates	Mechanistic	DGIdb
PRILOCAINE HYDROCHLORIDE	? unclear	Mechanistic	DGIdb
CLENBUTEROL	↑ activates	Mechanistic	DGIdb
PROPRANOLOL HYDROCHLORIDE	↓ inhibits	Mechanistic	DGIdb
INDACATEROL MALEATE	↑ activates	Mechanistic	DGIdb
VILANTEROL	? unclear	Mechanistic	DGIdb
TERTATOLOL	? unclear	Mechanistic	DGIdb
ARFORMOTEROL	↑ activates	Mechanistic	DGIdb
INDACATEROL	? unclear	Mechanistic	DGIdb
FORMOTEROL FUMARATE	↑ activates	Mechanistic	DGIdb
CHEMBL:CHEMBL111201	? unclear	Mechanistic	DGIdb
RITODRINE	? unclear	Mechanistic	DGIdb
RISPERIDONE	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL599896	? unclear	Mechanistic	DGIdb
VILANTEROL TRIFENATATE	↑ activates	Mechanistic	DGIdb
RITODRINE HYDROCHLORIDE	↑ activates	Mechanistic	DGIdb
DISULFIRAM	? unclear	Mechanistic	DGIdb
BUCINDOLOL HYDROCHLORIDE	↓ inhibits	Mechanistic	DGIdb
LEVALBUTEROL TARTRATE	↑ activates	Mechanistic	DGIdb
LAS190792	↑ activates	Mechanistic	DGIdb
ALPRENOLOL	? unclear	Mechanistic	DGIdb
CELIPROLOL	↑ activates	Mechanistic	DGIdb
ALBUTEROL SULFATE	↑ activates	Mechanistic	DGIdb
CARTEOLOL	? unclear	Mechanistic	DGIdb

Showing top 40 of 335 agents ranked by evidence tier.

CXCR2

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
BEVACIZUMAB	? unclear	Mechanistic		DGIdb
DANIRIXIN	↓ inhibits	Mechanistic		DGIdb
AZD-5122	? unclear	Mechanistic		DGIdb
CLOTRIMAZOLE	? unclear	Mechanistic		DGIdb
ALPHA-TOCOPHEROL	? unclear	Mechanistic		DGIdb
NAVARIXIN	? unclear	Mechanistic		DGIdb
LADARIXIN	~ modulates	Mechanistic		DGIdb
GENISTEIN	? unclear	Mechanistic		DGIdb
ACETYLCYSTEINE	? unclear	Mechanistic		DGIdb
ELUBRIXIN	↓ inhibits	Mechanistic		DGIdb
VIMNERIXIN	? unclear	Mechanistic		DGIdb
REPARIXIN	~ modulates	Mechanistic		DGIdb
CANOCTAKIN	? unclear	Mechanistic		DGIdb
MECHLORETHAMINE	? unclear	Mechanistic		DGIdb
IBUPROFEN, SODIUM SALT	? unclear	Mechanistic		DGIdb
SX-682	↓ inhibits	Mechanistic		DGIdb
CYCLOPHOSPHAMIDE ANHYDROUS	? unclear	Mechanistic		DGIdb
NAVARIXIN ANHYDROUS	? unclear	Mechanistic	2.6 nM (IC50)	Open Targets
CHEMBL25573	↓ inhibits	Mechanistic	200.0 nM (IC50)	ChEMBL
CHEMBL27863	↓ inhibits	Mechanistic	25.0 nM (IC50)	ChEMBL
CHEMBL283736	↓ inhibits	Mechanistic	860.0 nM (IC50)	ChEMBL
CHEMBL280711	↓ inhibits	Mechanistic	320.0 nM (IC50)	ChEMBL
CHEMBL27446	↓ inhibits	Mechanistic	22.0 nM (IC50)	ChEMBL
CHEMBL28009	↓ inhibits	Mechanistic	6.0 nM (IC50)	ChEMBL
CHEMBL24912	↓ inhibits	Mechanistic	10900.0 nM (IC50)	ChEMBL
CHEMBL26830	↓ inhibits	Mechanistic	57.0 nM (IC50)	ChEMBL
CHEMBL312883	↓ inhibits	Mechanistic	3500.0 nM (IC50)	ChEMBL
CHEMBL85872	↓ inhibits	Mechanistic	2800.0 nM (IC50)	ChEMBL
CHEMBL86002	↓ inhibits	Mechanistic	2000.0 nM (IC50)	ChEMBL
CHEMBL85267	↓ inhibits	Mechanistic	2400.0 nM (IC50)	ChEMBL
CHEMBL83292	↓ inhibits	Mechanistic	670.0 nM (IC50)	ChEMBL
CHEMBL310634	↓ inhibits	Mechanistic	4400.0 nM (IC50)	ChEMBL
CHEMBL84957	↓ inhibits	Mechanistic	1400.0 nM (IC50)	ChEMBL
CHEMBL313465	↓ inhibits	Mechanistic	730.0 nM (IC50)	ChEMBL
CHEMBL82566	↓ inhibits	Mechanistic	92.0 nM (IC50)	ChEMBL
CHEMBL85045	↓ inhibits	Mechanistic	450.0 nM (IC50)	ChEMBL
CHEMBL87282	↓ inhibits	Mechanistic	1400.0 nM (IC50)	ChEMBL
CHEMBL86284	↓ inhibits	Mechanistic	830.0 nM (IC50)	ChEMBL
CHEMBL84719	↓ inhibits	Mechanistic	3500.0 nM (IC50)	ChEMBL
CHEMBL315206	↓ inhibits	Mechanistic	4200.0 nM (IC50)	ChEMBL

Showing top 40 of 207 agents ranked by evidence tier.

ELANE

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
SIVELESTAT	↓ inhibits	Mechanistic		DGIdb
ALVELESTAT	↓ inhibits	Mechanistic		DGIdb
NIFEDIPINE	? unclear	Mechanistic		DGIdb
NICOTINE POLACRILEX	? unclear	Mechanistic		DGIdb
TIPRELESTAT	? unclear	Mechanistic		DGIdb
COMPOUND 17 [PMID: 23642479]	↓ inhibits	Mechanistic		DGIdb
.ALPHA.1-PROTEINASE INHIBITOR HUMAN	↓ inhibits	Mechanistic		DGIdb
LORECIVIVINT	↓ inhibits	Mechanistic		DGIdb
TAKINIB	↓ inhibits	Mechanistic		DGIdb
ALPHA 1-ANTITRYPSIN	? unclear	Mechanistic		DGIdb
SIVELESTAT SODIUM	? unclear	Mechanistic		DGIdb
ROGOCEKIB	↓ inhibits	Mechanistic		DGIdb
DEPELESTAT	↓ inhibits	Mechanistic		DGIdb
ML315	↓ inhibits	Mechanistic		DGIdb
MW01	↓ inhibits	Mechanistic		DGIdb
SYMPLOSTATIN 5	? unclear	Mechanistic		DGIdb
MW05	↓ inhibits	Mechanistic		DGIdb
LONODELESTAT	? unclear	Mechanistic		DGIdb
ERDOSTEINE	? unclear	Mechanistic		DGIdb
COMPOUND 20 [PMID: 30998356]	↓ inhibits	Mechanistic		DGIdb
CHEMBL:CHEMBL310871	? unclear	Mechanistic		DGIdb
ELAFIN	? unclear	Mechanistic		DGIdb
CIRTUVIVINT	↓ inhibits	Mechanistic		DGIdb
EPIGALLOCATECHIN GALLATE	? unclear	Mechanistic		DGIdb
CHEMBL314218	↓ inhibits	Mechanistic	0.03 nM (Ki)	ChEMBL
CHEMBL274085	↓ inhibits	Mechanistic	2.7 nM (Ki)	ChEMBL
CHEMBL329376	↓ inhibits	Mechanistic	31.0 nM (Ki)	ChEMBL
CHEMBL543416	↓ inhibits	Mechanistic	0.014 nM (Ki)	ChEMBL
CHEMBL51377	↓ inhibits	Mechanistic	102.0 nM (Ki)	ChEMBL
CHEMBL432049	↓ inhibits	Mechanistic	0.17 nM (Ki)	ChEMBL
CHEMBL89299	↓ inhibits	Mechanistic	8.0 nM (Ki)	ChEMBL
CHEMBL95813	↓ inhibits	Mechanistic	300.0 nM (IC50)	ChEMBL
CHEMBL330647	↓ inhibits	Mechanistic	25000.0 nM (IC50)	ChEMBL
CHEMBL91944	↓ inhibits	Mechanistic	0.06 nM (Ki)	ChEMBL
CHEMBL318052	↓ inhibits	Mechanistic	36000.0 nM (IC50)	ChEMBL
CHEMBL319173	↓ inhibits	Mechanistic	1200.0 nM (IC50)	ChEMBL
CHEMBL2368616	↓ inhibits	Mechanistic	0.31 nM (Ki)	ChEMBL
CHEMBL554013	↓ inhibits	Mechanistic	1.73 nM (Ki)	ChEMBL
CHEMBL90730	↓ inhibits	Mechanistic	26.0 nM (Ki)	ChEMBL
CHEMBL421162	↓ inhibits	Mechanistic	1.0 nM (Ki)	ChEMBL

Showing top 40 of 210 agents ranked by evidence tier.

MMP12

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
MARIMASTAT	↓ inhibits	Mechanistic		DGIdb
ILOMASTAT	? unclear	Mechanistic	13.0 nM (IC50)	DGIdb
ACETAZOLAMIDE	? unclear	Mechanistic		DGIdb
NEOVASTAT	↓ inhibits	Mechanistic		DGIdb
DEFEROXAMINE	? unclear	Mechanistic		DGIdb
CTS-1027	↓ inhibits	Mechanistic		DGIdb
CAPTOPRIL	? unclear	Mechanistic		DGIdb
ZILEUTON	? unclear	Mechanistic		DGIdb
AZD-1236	↓ inhibits	Mechanistic		DGIdb
CHEMBL1788203	↓ inhibits	Mechanistic	42.0 nM (IC50)	ChEMBL
CHEMBL263501	↓ inhibits	Mechanistic	12.0 nM (IC50)	ChEMBL
CHEMBL2092878	↓ inhibits	Mechanistic	9.0 nM (IC50)	ChEMBL
CHEMBL77258	↓ inhibits	Mechanistic	14.0 nM (IC50)	ChEMBL
CHEMBL78001	↓ inhibits	Mechanistic	13.0 nM (IC50)	ChEMBL
CHEMBL148406	↓ inhibits	Mechanistic	191.0 nM (IC50)	ChEMBL
CHEMBL147882	↓ inhibits	Mechanistic	29.0 nM (IC50)	ChEMBL
CHEMBL148171	↓ inhibits	Mechanistic	65.0 nM (IC50)	ChEMBL
CHEMBL424130	↓ inhibits	Mechanistic	170.0 nM (IC50)	ChEMBL
CHEMBL147881	↓ inhibits	Mechanistic	57.0 nM (IC50)	ChEMBL
CHEMBL148214	↓ inhibits	Mechanistic	20.0 nM (IC50)	ChEMBL
CHEMBL356124	↓ inhibits	Mechanistic	7689.0 nM (IC50)	ChEMBL
CHEMBL358539	↓ inhibits	Mechanistic	57.0 nM (IC50)	ChEMBL
CHEMBL147489	↓ inhibits	Mechanistic	59.0 nM (IC50)	ChEMBL
CHEMBL147604	↓ inhibits	Mechanistic	931.0 nM (IC50)	ChEMBL
CHEMBL146718	↓ inhibits	Mechanistic	72.0 nM (IC50)	ChEMBL
CHEMBL146289	↓ inhibits	Mechanistic	421.0 nM (IC50)	ChEMBL
CHEMBL431680	↓ inhibits	Mechanistic	390.0 nM (Ki)	ChEMBL
CHEMBL325163	↓ inhibits	Mechanistic	2000.0 nM (Ki)	ChEMBL
CHEMBL114878	↓ inhibits	Mechanistic	35.0 nM (Ki)	ChEMBL
CHEMBL116944	↓ inhibits	Mechanistic	3.5 nM (IC50)	ChEMBL
CHEMBL118497	↓ inhibits	Mechanistic	2.6 nM (IC50)	ChEMBL
CHEMBL290377	↓ inhibits	Mechanistic	8.2 nM (IC50)	ChEMBL
CHEMBL77163	↓ inhibits	Mechanistic	1.7 nM (IC50)	ChEMBL
CHEMBL111856	↓ inhibits	Mechanistic	0.24 nM (IC50)	ChEMBL
CHEMBL77995	↓ inhibits	Mechanistic	4.0 nM (IC50)	ChEMBL
CHEMBL78233	↓ inhibits	Mechanistic	93.0 nM (IC50)	ChEMBL
CHEMBL308277	↓ inhibits	Mechanistic	5.0 nM (IC50)	ChEMBL
CHEMBL321213	↓ inhibits	Mechanistic	280.0 nM (Ki)	ChEMBL
CHEMBL110750	↓ inhibits	Mechanistic	440.0 nM (Ki)	ChEMBL
CHEMBL109770	↓ inhibits	Mechanistic	300.0 nM (Ki)	ChEMBL

Showing top 40 of 181 agents ranked by evidence tier.

MMP9

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
CURCUMIN PYRAZOLE	? unclear	Mechanistic		DGIdb
TST10088	? unclear	Mechanistic		DGIdb
CELECOXIB	? unclear	Mechanistic		DGIdb
CURCUMIN	? unclear	Mechanistic		DGIdb
TOZULERISTIDE	? unclear	Mechanistic		DGIdb
SHARK CARTILAGE EXTRACT AE-941	? unclear	Mechanistic		DGIdb
HYDRALAZINE	? unclear	Mechanistic		DGIdb
ULINASTATIN	? unclear	Mechanistic		DGIdb
BEVACIZUMAB	? unclear	Mechanistic		DGIdb
CARBOXYLATED GLUCOSAMINE	? unclear	Mechanistic		DGIdb
METHYLDOPA ANHYDROUS	? unclear	Mechanistic		DGIdb
ANDECALIXIMAB	↓ inhibits	Mechanistic		DGIdb
DP-B99	? unclear	Mechanistic		DGIdb
NEOVASTAT	↓ inhibits	Mechanistic		DGIdb
PRINOMASTAT	? unclear	Mechanistic	0.2 nM (IC50)	DGIdb
REBIMASTAT	↓ inhibits	Mechanistic		DGIdb
INCYCLINIDE	? unclear	Mechanistic		DGIdb
CTS-1027	↓ inhibits	Mechanistic	3.0 nM (IC50)	DGIdb
DEMETHYLWEDELOLACTONE	? unclear	Mechanistic		DGIdb
S-3304	? unclear	Mechanistic	23.0 nM (IC50)	DGIdb
ILOMASTAT	? unclear	Mechanistic		DGIdb
MARIMASTAT	↓ inhibits	Mechanistic	1.5 nM (IC50)	DGIdb
AZD-1236	↓ inhibits	Mechanistic		DGIdb
ANTIHYPERTENSIVE AGENT	? unclear	Mechanistic		DGIdb
NIFEDIPINE	? unclear	Mechanistic		DGIdb
CHEMBL435271	↓ inhibits	Mechanistic	5.0 nM (Ki)	ChEMBL
CHEMBL80814	↓ inhibits	Mechanistic	34.0 nM (IC50)	ChEMBL
CHEMBL276119	↓ inhibits	Mechanistic	9.0 nM (IC50)	ChEMBL
CHEMBL78934	↓ inhibits	Mechanistic	20.0 nM (IC50)	ChEMBL
CHEMBL78369	↓ inhibits	Mechanistic	3.0 nM (IC50)	ChEMBL
CGS-27023A	↓ inhibits	Mechanistic	9.0 nM (IC50)	ChEMBL
CHEMBL167278	↓ inhibits	Mechanistic	2.0 nM (Ki)	ChEMBL
CHEMBL169996	↓ inhibits	Mechanistic	34.0 nM (Ki)	ChEMBL
CHEMBL80453	↓ inhibits	Mechanistic	44.0 nM (IC50)	ChEMBL
CHEMBL303983	↓ inhibits	Mechanistic	291.0 nM (Ki)	ChEMBL
CHEMBL312432	↓ inhibits	Mechanistic	6.0 nM (IC50)	ChEMBL
CHEMBL306617	↓ inhibits	Mechanistic	5.0 nM (IC50)	ChEMBL
CHEMBL79111	↓ inhibits	Mechanistic	43.0 nM (IC50)	ChEMBL
CHEMBL78798	↓ inhibits	Mechanistic	2.0 nM (IC50)	ChEMBL
CHEMBL80969	↓ inhibits	Mechanistic	10.0 nM (IC50)	ChEMBL

Showing top 40 of 212 agents ranked by evidence tier.

MUC5AC

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Source
YTTRIUM Y 90 CLIVATUZUMAB TETRAXETAN	~ modulates	Mechanistic	DGIdb
ENSITUXIMAB	? unclear	Mechanistic	DGIdb
CLIVATUZUMAB TETRAXETAN	~ modulates	Mechanistic	DGIdb
THERAPEUTIC GLUCOCORTICOID	? unclear	Mechanistic	DGIdb

NFE2L2

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Source
CHEMBL:CHEMBL1537417	? unclear	Mechanistic	DGIdb
SIMVASTATIN	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL591631	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL578929	? unclear	Mechanistic	DGIdb
MIFEPRISTONE	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL224318	? unclear	Mechanistic	DGIdb
ROSIGLITAZONE MALEATE	? unclear	Mechanistic	DGIdb
DICUMAROL	? unclear	Mechanistic	DGIdb
2-NITROFLUORENE	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL530291	? unclear	Mechanistic	DGIdb
PREDNICARBATE	? unclear	Mechanistic	DGIdb
5-FLUOROURIDINE	? unclear	Mechanistic	DGIdb
BENZO[E]PYRENE	? unclear	Mechanistic	DGIdb
DIPHENADIONE	? unclear	Mechanistic	DGIdb
RABEPRAZOLE	? unclear	Mechanistic	DGIdb
DEXAMETHASONE SODIUM PHOSPHATE	? unclear	Mechanistic	DGIdb
2-METHOXY-1,4-NAPHTHOQUINONE	? unclear	Mechanistic	DGIdb
DINITRO CRESOL	? unclear	Mechanistic	DGIdb
ALDICARB	? unclear	Mechanistic	DGIdb
VITAMIN A	? unclear	Mechanistic	DGIdb
ANTIMYCIN A	? unclear	Mechanistic	DGIdb
MELENGESTROL ACETATE	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL168075	? unclear	Mechanistic	DGIdb
WORTMANNIN	? unclear	Mechanistic	DGIdb
BROMOCRIPTINE MESYLATE	? unclear	Mechanistic	DGIdb
HEXYLRESORCINOL	? unclear	Mechanistic	DGIdb
ISOFLUPREDONE ACETATE	? unclear	Mechanistic	DGIdb
LITHIUM	? unclear	Mechanistic	DGIdb
1-NAPHTHOL	? unclear	Mechanistic	DGIdb
BENZO[B]FLUORANTHENE	? unclear	Mechanistic	DGIdb
NANAOMYCIN	? unclear	Mechanistic	DGIdb
NIFEDIPINE	? unclear	Mechanistic	DGIdb
2-AMINOANTHRACENE	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL426404	? unclear	Mechanistic	DGIdb
METHOTREXATE	? unclear	Mechanistic	DGIdb
E1501	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL1329443	? unclear	Mechanistic	DGIdb
CHEMBL:CHEMBL531710	? unclear	Mechanistic	DGIdb
METHYLPREDNISOLONE ACETATE	? unclear	Mechanistic	DGIdb
AZAMETHIPHOS	? unclear	Mechanistic	DGIdb

Showing top 40 of 1025 agents ranked by evidence tier.

PDE4D

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
CILOMILAST	↓ inhibits	Mechanistic	63.0 nM (IC50)	DGIdb
TRANIMILAST	↓ inhibits	Mechanistic		DGIdb
RESVERATROL	? unclear	Mechanistic		DGIdb
DIFAMILAST	↓ inhibits	Mechanistic		DGIdb
MK-0873	↓ inhibits	Mechanistic		DGIdb
REVAMILAST	↓ inhibits	Mechanistic		DGIdb
THEOPHYLLINE	↓ inhibits	Mechanistic		DGIdb
DYPHYLLINE	↓ inhibits	Mechanistic		DGIdb
IBUDILAST	↓ inhibits	Mechanistic		DGIdb
HT-0712	↓ inhibits	Mechanistic		DGIdb
ENSIFENTRINE	↓ inhibits	Mechanistic		DGIdb
LIRIMILAST	? unclear	Mechanistic		DGIdb
OXTRIPHYLLINE	↓ inhibits	Mechanistic		DGIdb
DROTAVERIN	↓ inhibits	Mechanistic		DGIdb
TOFIMILAST	↓ inhibits	Mechanistic		DGIdb
THEOPHYLLINE SODIUM GLYCINATE	↓ inhibits	Mechanistic		DGIdb
DIPYRIDAMOLE	↓ inhibits	Mechanistic		DGIdb
GSK-356278	? unclear	Mechanistic		DGIdb
APREMILAST	↓ inhibits	Mechanistic		DGIdb
ETAZOLATE	? unclear	Mechanistic		DGIdb
OGLEMILAST	↓ inhibits	Mechanistic		DGIdb
ZATOLMILAST	↓ inhibits	Mechanistic		DGIdb
TETOMILAST	↓ inhibits	Mechanistic		DGIdb
ROLIPRAM	↓ inhibits	Mechanistic	390.0 nM (IC50)	DGIdb
DENBUFYLLINE	? unclear	Mechanistic		DGIdb
LOTAMILAST	↓ inhibits	Mechanistic		DGIdb
PENTOXIFYLLINE	↓ inhibits	Mechanistic		DGIdb
AMLEXANOX	↓ inhibits	Mechanistic		DGIdb
AMINOPHYLLINE	↓ inhibits	Mechanistic		DGIdb
CRISABOROLE	↓ inhibits	Mechanistic		DGIdb
ROFLUMILAST	↓ inhibits	Mechanistic		DGIdb
PICLAMILAST	? unclear	Mechanistic	0.8 nM (IC50)	DGIdb
PAPAVERINE	? unclear	Mechanistic		DGIdb
GSK-256066	↓ inhibits	Mechanistic		DGIdb
DIURETIC	? unclear	Mechanistic		DGIdb
BPN14770	? unclear	Mechanistic		DGIdb
FLAVOXATE HYDROCHLORIDE	↓ inhibits	Mechanistic		DGIdb
SELECTIVE CYTOKINE INHIBITORY DRUG CC-1088	? unclear	Mechanistic		DGIdb
DOVRAMILAST	↓ inhibits	Mechanistic		DGIdb
QUETIAPINE FUMARATE	? unclear	Mechanistic		DGIdb

Showing top 40 of 184 agents ranked by evidence tier.

SERPINA1

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
ALPHA 1-ANTITRYPSIN	? unclear	Mechanistic		DGIdb
IGMESINE	? unclear	Mechanistic		DGIdb

TGFB1

UniProt Ensembl DGIdb Open Targets

Therapeutic Agent	Effect Direction	Evidence Tier	Potency	Source
INTERFERON ALFA-2B	? unclear	Mechanistic		DGIdb
PIOGLITAZONE HYDROCHLORIDE	? unclear	Mechanistic		DGIdb
SILYMARIN	? unclear	Mechanistic		DGIdb
RITUXIMAB	? unclear	Mechanistic		DGIdb
VERAPAMIL	? unclear	Mechanistic		DGIdb
PROTEASOME INHIBITOR	? unclear	Mechanistic		DGIdb
FRESOLIMUMAB	? unclear	Mechanistic		DGIdb
ATENOLOL	? unclear	Mechanistic		DGIdb
BINTRAFUSP ALFA	~ modulates	Mechanistic		DGIdb
NISEVOKITUG	? unclear	Mechanistic		DGIdb
LUSPATERCEPT	↓ inhibits	Mechanistic		DGIdb
TRETINOIN	? unclear	Mechanistic		DGIdb
HYDROCORTISONE BUTYRATE	? unclear	Mechanistic		DGIdb
VITAMIN E	? unclear	Mechanistic		DGIdb
IRINOTECAN HYDROCHLORIDE	? unclear	Mechanistic		DGIdb
INOSITOL	? unclear	Mechanistic		DGIdb
NICOTINE POLACRILEX	? unclear	Mechanistic		DGIdb
FENRETINIDE	? unclear	Mechanistic		DGIdb
MELATONIN	? unclear	Mechanistic		DGIdb
ISOTRETINOIN	? unclear	Mechanistic		DGIdb
VACTOSERTIB	? unclear	Mechanistic	12.9 nM (IC50)	DGIdb
TRIAMCINOLONE	? unclear	Mechanistic		DGIdb
TAMOXIFEN	? unclear	Mechanistic		DGIdb
ADRIAMYCIN	? unclear	Mechanistic		DGIdb
HEPARAN SULFATE	? unclear	Mechanistic		DGIdb
GOSSYPOL	? unclear	Mechanistic		DGIdb
TCDD	? unclear	Mechanistic		DGIdb
AMIFOSTINE ANHYDROUS	? unclear	Mechanistic		DGIdb
RAMIPRIL	? unclear	Mechanistic		DGIdb
ANTIOXIDANT	? unclear	Mechanistic		DGIdb
SOTATERCEPT	? unclear	Mechanistic		DGIdb
ASPIRIN	? unclear	Mechanistic		DGIdb
GALUNISERTIB	? unclear	Mechanistic		DGIdb
KEYHOLE LIMPET HEMOCYANIN	? unclear	Mechanistic		DGIdb
PIRFENIDONE	? unclear	Mechanistic		DGIdb
H2O2	? unclear	Mechanistic		DGIdb
THERAPEUTIC ANDROGEN	? unclear	Mechanistic		DGIdb
SANDOSTATIN	? unclear	Mechanistic		DGIdb
BROXURIDINE	? unclear	Mechanistic		DGIdb
DISITERTIDE	? unclear	Mechanistic		DGIdb

Showing top 40 of 62 agents ranked by evidence tier.

Clinical Trials

Recruiting and recently completed trials from ClinicalTrials.gov. Data retrieved 2026-07-06.

No recent clinical trials found on ClinicalTrials.gov for this condition.

Agents Found By Disease-Level Search

Searched directly from “COPD” via ClinicalTrials.gov interventions and Open Targets' disease→drug data — independent of the 10-gene target panel above. This surfaces agents whose mechanism doesn't route through a curated gene (combination therapies, standard-of-care drugs, targets outside the panel).

60 agents shown (approved or with trial evidence) — 56 not found by the gene-target search above.

RV568NOT in gene-target list

· 2 trials · source: ClinicalTrials.gov
NCT01475292 NCT01475292

Atrovent Respimat (20 mcg)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00400153

COMBIVENT MDI (36/206 mcg)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00400153

Combivent Respimat (20 mcg/100 mcg)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00400153

Placebo via corresponding inhaler for blinding purposesNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00400153

Handgrip strengthNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06220851

Roflumilast

Approved · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT04069312

AzithromycinNOT in gene-target list

Approved · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT04069312

S1226(8%)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02334553

BCG vaccine (Danish strain 1331)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06257212

MMR VaccineNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06257212

EducationNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00268866

Hyperpolarized Xenon-129 MRI (Experimental)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03331302

Radioactive Xenon-133 scintigraphy (Active Comparator)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03331302

Interdisciplinary interventionNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT07394712

Neural respiratory drive measurementNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03443505

Conventional resistance training programNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT01135966

Whole body vibration resistance training programNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT01135966

Lung SealantNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05396131

Endobronchial Valve (EBV)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05396131

oxidative and antioxidant biomarkersNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02406053

Low-Dose Computed TomographyNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02599883

Aclidinium bromideNOT in gene-target list

Approved · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT01462929

Tiotropium

Approved · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT01462929

Adjustable bed backrestNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT04963205

Veno-veno-arterial ECMONOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02859194

Test Product (tiotropium bromide inhalation powder)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05161156

18 mcg of Spiriva (Reference Product)NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05161156

Use different methods of teachingNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT05374629

Treprostinil Inhalation Solution 36 mcgNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06969573

Treprostinil Inhalation Solution 78 mcgNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT06969573

Induced sputumNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00655954

Regimen ANOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03311373

Regimen BNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03311373

Regimen CNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03311373

Regimen DNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03311373

InsulinNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00764556

CHF1535NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00929851

Formoterol fumarate

Approved · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT00929851

GSK573719/GW642444 125/25mcgNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT01313637

GSK573719 125mcgNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT01313637

GW642444 25mcgNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT01313637

Placebo onlyNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT01313637

HUI score cardNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00457301

CM326 dose 1NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT07418736

CM326 dose 2NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT07418736

AZD2115 Dose 1NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02109406

AZD 2115, Dose 2NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02109406

Placebo MDINOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02109406

pMDI Triple Inhaler OnlyNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT07030881

GSK2269557NOT in gene-target list

Phase 2 · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT02522299

DISKUSNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02522299

ELLIPTANOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02522299

Pedometer and WebsiteNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02099799

Itepekimab SAR440340NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT04751487

Complete enteral formulaNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02102009

Tiotropium Inhalation SolutionNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT00168844

Timed Up and GoNOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT03152344

Megestrol acetate

Phase 2 · 1 trial · source: ClinicalTrials.gov, Open Targets
NCT00507949

QVA149NOT in gene-target list

· 1 trial · source: ClinicalTrials.gov
NCT02233543

COPD

Remission & chronicity

ADRB2

CXCR2

ELANE

MMP12

MMP9

MUC5AC

NFE2L2

PDE4D

SERPINA1

TGFB1

RV568NOT in gene-target list

Atrovent Respimat (20 mcg)NOT in gene-target list

COMBIVENT MDI (36/206 mcg)NOT in gene-target list

Combivent Respimat (20 mcg/100 mcg)NOT in gene-target list

Placebo via corresponding inhaler for blinding purposesNOT in gene-target list

Handgrip strengthNOT in gene-target list

Roflumilast

AzithromycinNOT in gene-target list

S1226(8%)NOT in gene-target list

BCG vaccine (Danish strain 1331)NOT in gene-target list

MMR VaccineNOT in gene-target list

EducationNOT in gene-target list

Hyperpolarized Xenon-129 MRI (Experimental)NOT in gene-target list

Radioactive Xenon-133 scintigraphy (Active Comparator)NOT in gene-target list

Interdisciplinary interventionNOT in gene-target list

Neural respiratory drive measurementNOT in gene-target list

Conventional resistance training programNOT in gene-target list

Whole body vibration resistance training programNOT in gene-target list

Lung SealantNOT in gene-target list

Endobronchial Valve (EBV)NOT in gene-target list

oxidative and antioxidant biomarkersNOT in gene-target list

Low-Dose Computed TomographyNOT in gene-target list

Aclidinium bromideNOT in gene-target list

Tiotropium

Adjustable bed backrestNOT in gene-target list

Veno-veno-arterial ECMONOT in gene-target list

Test Product (tiotropium bromide inhalation powder)NOT in gene-target list

18 mcg of Spiriva (Reference Product)NOT in gene-target list

Use different methods of teachingNOT in gene-target list

Treprostinil Inhalation Solution 36 mcgNOT in gene-target list

Treprostinil Inhalation Solution 78 mcgNOT in gene-target list

Induced sputumNOT in gene-target list

Regimen ANOT in gene-target list

Regimen BNOT in gene-target list

Regimen CNOT in gene-target list

Regimen DNOT in gene-target list

InsulinNOT in gene-target list

CHF1535NOT in gene-target list

Formoterol fumarate

GSK573719/GW642444 125/25mcgNOT in gene-target list

GSK573719 125mcgNOT in gene-target list

GW642444 25mcgNOT in gene-target list

Placebo onlyNOT in gene-target list

HUI score cardNOT in gene-target list

CM326 dose 1NOT in gene-target list

CM326 dose 2NOT in gene-target list

AZD2115 Dose 1NOT in gene-target list

AZD 2115, Dose 2NOT in gene-target list

Placebo MDINOT in gene-target list

pMDI Triple Inhaler OnlyNOT in gene-target list

GSK2269557NOT in gene-target list

DISKUSNOT in gene-target list

ELLIPTANOT in gene-target list

Pedometer and WebsiteNOT in gene-target list

Itepekimab SAR440340NOT in gene-target list

Complete enteral formulaNOT in gene-target list

Tiotropium Inhalation SolutionNOT in gene-target list

Timed Up and GoNOT in gene-target list

Megestrol acetate

QVA149NOT in gene-target list

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