Three-month treatment response and exacerbation in chronic obstructive pulmonary disease

J Korean Med Sci. 2015 Jan;30(1):54-9. doi: 10.3346/jkms.2015.30.1.54. Epub 2014 Dec 23.

Abstract

The aim of this study was to investigate relationships between acute exacerbation and Forced Expiratory Volume 1 second (FEV1) improvement after treatment with combined long-acting beta-agonist (LABA) and inhaled corticosteroid (ICS) in patients with chronic obstructive pulmonary disease (COPD). A total of 137 COPD patients were classified as responders or nonresponders according to FEV1 improvement after 3 months of LABA/ICS treatment in fourteen referral hospitals in Korea. Exacerbation occurrence in these two subgroups was compared over a period of 1 yr. Eighty of the 137 COPD patients (58.4%) were classified as responders and 57 (41.6%) as nonresponders. Acute exacerbations occurred in 25 patients (31.3%) in the responder group and in 26 patients (45.6%) in the nonresponder group (P=0.086). FEV1 improvement after LABA/ICS treatment was a significant prognostic factor for fewer acute exacerbations in a multivariate Cox proportional hazard model adjusted for age, sex, FEV1, smoking history, 6 min walk distance, body mass index, exacerbation history in the previous year, and dyspnea scale.Three-month treatment response to LABA/ICS might be a prognostic factor for the occurrence of acute exacerbation in COPD patients.

Keywords: Disease Progression; Forced Expiratory Volume; Pulmonary Disease, Chronic Obstructive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adrenergic beta-2 Receptor Agonists / therapeutic use*
  • Bronchodilator Agents / therapeutic use*
  • Budesonide / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Fluticasone / therapeutic use
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology*
  • Formoterol Fumarate / therapeutic use
  • Humans
  • Male
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Recurrence
  • Republic of Korea
  • Salmeterol Xinafoate / therapeutic use
  • Smoking
  • Spirometry
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-2 Receptor Agonists
  • Bronchodilator Agents
  • Budesonide
  • Salmeterol Xinafoate
  • Fluticasone
  • Formoterol Fumarate