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Therapeutic Response to Single-Inhaler Triple Therapies in Moderate-to-Severe COPD.
- Source :
- Respiratory Care; Mar2023, Vol. 68 Issue 3, p330-337, 8p
- Publication Year :
- 2023
-
Abstract
- BACKGROUND: COPD is characterized by progressive and irreversible air flow limitations. Single-inhaler therapies (SITTs) incorporating an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting β<subscript>2</subscript>-agonist have been shown to effectively alleviate symptoms and improve lung function. Fluticasone-furoate/umeclidinium/vilanterol (F/U/V) and budesonide/glyco-pyrronium/formoterol (B/G/F) are available as SITT in Japan. However, the clinical differences between these 2 combinations and the predictors of their proper use have not been established. This study aimed to identify the subject characteristics that could predict the effectiveness of inhaler therapy. METHODS: We assessed the pulmonary function test results of subjects with COPD before and one month after using F/U/V and B/G/F as SITT. Subjects with a difference of 100 mL or more in the FEV<subscript>1</subscript> after treatment with pre-SITT were extracted and divided into the F/U/V effect and no-effect group and B/G/F effect and no-effect group to examine the factors associated with positive outcomes with each inhaler. RESULTS: F/U/V and B/G/F significantly improved the inspiratory capacity (IC), %IC, FVC, and %FEV<subscript>1</subscript> when compared to pre-inter-vention values (P < .001, P = .001, P = .007, P = .009, respectively, for F/U/V; and P = .006, P = .008, P = .038, P = .005, respectively, for B/G/F). Factors associated with FEV1 improvement in F/U/V included lower %IC (odds ratio 0.97 [95% CI 0.94-0.99], P = .03) and a higher modified Medical Research Council (mMRC) dyspnea score (2.36 [1.27-4.70], P < .01). In addition, a higher %IC (1.03 [1.00-1.06], P = .02) and lower mMRC dyspnea score (0.55 [0.28-0.99], P = .041) were predictors for the effectiveness of B/G/F. CONCLUSIONS: Our results showed that SITT significantly improved the IC, %IC, FVC, and %FEV<subscript>1</subscript> when compared to pre-inter-vention and that F/U/V was more effective in subjects with severe symptoms, whereas B/G/F was more effective in subjects with mild symptoms. [ABSTRACT FROM AUTHOR]
- Subjects :
- ADRENERGIC beta agonists
STATISTICS
COMBINATION drug therapy
CONFIDENCE intervals
ANALYSIS of variance
CONTINUING education units
MANN Whitney U Test
SEVERITY of illness index
TREATMENT effectiveness
COMPARATIVE studies
T-test (Statistics)
OBSTRUCTIVE lung diseases
PULMONARY function tests
DESCRIPTIVE statistics
INHALATION administration
ODDS ratio
DATA analysis
DATA analysis software
SENSITIVITY & specificity (Statistics)
MUSCARINIC antagonists
BECLOMETHASONE dipropionate
Subjects
Details
- Language :
- English
- ISSN :
- 00201324
- Volume :
- 68
- Issue :
- 3
- Database :
- Supplemental Index
- Journal :
- Respiratory Care
- Publication Type :
- Academic Journal
- Accession number :
- 162192222
- Full Text :
- https://doi.org/10.4187/respcare.10188