Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 6

Comparison of efficacy of long-acting bronchodilators in emphysema dominant and emphysema nondominant chronic obstructive pulmonary disease

Authors Fujimoto K, Kitaguchi Y, Kanda S, Urushihata K, Hanaoka M, Kubo K

Published 1 April 2011 Volume 2011:6 Pages 219—227

DOI https://doi.org/10.2147/COPD.S18461

Review by Single-blind

Peer reviewer comments 2

Keisaku Fujimoto1, Yoshiaki Kitaguchi2, Shintaro Kanda2, Kazuhisa Urushihata2, Masayuki Hanaoka2, Keishi Kubo2
1Department of Biomedical Laboratory Sciences, 2First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan

Background: The purpose of this study was to clarify the association between morphological phenotypes according to the predominance of emphysema and efficacy of long-acting muscarinic antagonist and β2 agonist bronchodilators in patients with chronic obstructive pulmonary disease (COPD).
Methods: Seventy-two patients with stable COPD treated with tiotropium (n = 41) or salmeterol (n = 31) were evaluated for pulmonary function, dynamic hyperinflation following metronome-paced incremental hyperventilation, six-minute walking distance, and St George’s Respiratory Questionnaire (SGRQ) before and 2–3 months following treatment with tiotropium or salmeterol. They were then visually divided into an emphysema dominant phenotype (n = 25 in the tiotropium-treated group and n = 22 in the salmeterol-treated group) and an emphysema nondominant phenotype on high-resolution computed tomography, and the efficacy of the two drugs in each phenotype was retrospectively analyzed.
Results: Tiotropium significantly improved airflow limitation, oxygenation, and respiratory impedance in both the emphysema dominant and emphysema nondominant phenotypes, and improved dynamic hyperinflation, exercise capacity, and SGRQ in the emphysema dominant phenotype but not in the emphysema nondominant phenotype. Salmeterol significantly improved total score for SGRQ in the emphysema phenotype, but no significant effects on other parameters were found for either of the phenotypes.
Conclusion: These findings suggest that tiotropium is more effective than salmeterol for airflow limitation regardless of emphysema dominance, and also can improve dynamic hyperinflation in the emphysema dominant phenotype, which results in further improvement of exercise capacity and health-related quality of life.

Keywords: emphysema, dynamic hyperinflation, long-acting β2 agonist, long-acting muscarinic antagonist, exercise capacity, quality of life

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Lactoferrin-modified PEGylated liposomes loaded with doxorubicin for targeting delivery to hepatocellular carcinoma

Wei MY, Guo XC, Tu LX, Zou Q, Li Q, Tang CY, Chen B, Xu YH, Wu CB

International Journal of Nanomedicine 2015, 10:5123-5137

Published Date: 12 August 2015

Central airways remodeling in COPD patients

Pini L, Pinelli V, Modina D, Bezzi M, Tiberio L, Tantucci C

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:927-933

Published Date: 1 September 2014

Clinical issues of mucus accumulation in COPD

Osadnik CR, McDonald CF, Holland AE

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:301-302

Published Date: 25 March 2014

Factors associated with good self-rated health and quality of life in subjects with self-reported COPD

Arne M, Lundin F, Boman G, Janson C, Janson S, Emtner M

International Journal of Chronic Obstructive Pulmonary Disease 2011, 6:511-519

Published Date: 7 October 2011

Tiotropium reduces risk of exacerbations irrespective of previous use of inhaled anticholinergics in placebo-controlled clinical trials

Cooper CB, Anzueto A, Decramer M, Celli B, Tashkin DP, Leimer I, Kesten S

International Journal of Chronic Obstructive Pulmonary Disease 2011, 6:269-275

Published Date: 9 May 2011

Bronchodilation improves endurance but not muscular efficiency in chronic obstructive pulmonary disease

van der Vaart H, Postma DS, Grevink R, Roemer W, ten Hacken NHT

International Journal of Chronic Obstructive Pulmonary Disease 2011, 6:229-235

Published Date: 8 April 2011