Responses to inhaled long-acting beta-agonist and corticosteroid according to COPD subtype
- Authors
- Lee, Ji-Hyun; Lee, Young Kyung; Kim, Eun-Kyung; Kim, Tae-Hyung; Huh, Jin Won; Kim, Woo Jin; Lee, Jin Hwa; Lee, Sang-Min; Lee, Sangyeub; Lim, Seong Yong; Shin, Tae Rim; Yoon, Ho Il; Sheen, Seung Soo; Kim, NamKug; Seo, Joon Beom; Oh, Yeon-Mok; Do Lee, Sang
- Issue Date
- 4월-2010
- Publisher
- W B SAUNDERS CO LTD
- Keywords
- COPD; Subtype; Inhaled long acting bronchodilator; Corticosteroid
- Citation
- RESPIRATORY MEDICINE, v.104, no.4, pp.542 - 549
- Indexed
- SCIE
SCOPUS
- Journal Title
- RESPIRATORY MEDICINE
- Volume
- 104
- Number
- 4
- Start Page
- 542
- End Page
- 549
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/116769
- DOI
- 10.1016/j.rmed.2009.10.024
- ISSN
- 0954-6111
- Abstract
- Rationale: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disorder in which a number of different pathological processes lead to recognition of patient subgroups that may have individual characteristics and distinct responses to treatment. Objectives: We tested the hypothesis that responses of lung function to 3 months of combined inhalation of long-acting beta-agonist and corticosteroid might differ among patients with various COPD subtypes. Methods: We classified 165 COPD patients into four subtypes according to the severity of emphysema and airflow obstruction: emphysema-dominant, obstruction-dominant, mild-mixed, and severe-mixed. The emphysema-dominant subtype was defined by an emphysema index on computed tomography of more than 20% and FEV1 more than 45% of the predicted value. The obstruction-dominant subtype had an emphysema index <= 20% and FEV1 <= 45%, the mild-mixed subtype had an emphysema index <= 20% and FEV1 > 45%, and the severe-mixed subtype had an emphysema index > 20% and FEV1 <= 45%. Patients were recruited prospectively and treated with 3 months of combined inhalation of long-acting beta-agonist and corticosteroid. Results: After 3 months of combined inhalation of long-acting beta-agonist and corticosteroid, obstruction-dominant subtype patients showed a greater FEV1 increase and more marked dyspnea improvement than did the emphysema-dominant subgroup. The mixed-subtype patients (both subgroups) also showed significant improvement in FEV1 compared with the emphysema-dominant subgroup. Emphysema-dominant subtype patients showed no improvement in FEV1 or dyspnea after the 3-month treatment period. Conclusion: The responses to 3 months of combined inhalation of long-acting beta-agonist and corticosteroid differed according to COPD subtype. (C) 2009 Elsevier Ltd. All rights reserved.
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