Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

Abstract

The WISDOM study (NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume in 1 second values recorded at home and in the clinic (mean difference of −0.05 L), which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2016

Publication date (Electronic): 22 August 2016

Volume: 11

Pages: 1973-1981

Affiliations

[1 ]Respiratory Institute, Servei de Pneumologia, Hospital Clínic IDIBAPS-CIBERES, Universitat de Barcelona, Barcelona, Spain

[2 ]Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany

[3 ]Department of Sports Medicine, University of Tübingen, Tübingen, Germany

[4 ]Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany

[5 ]Department of Respiratory Medicine, University Hospital Maastricht, Maastricht University, Maastricht, the Netherlands

[6 ]Department of Biostatistics and Data Sciences, Boehringer Ingelheim, Bracknell, UK

[7 ]Institute of Ageing and Chronic Disease, Aintree University Hospital, Liverpool, UK

Author notes

Correspondence: Roberto Rodriguez-Roisin, Respiratory Institute, Servei de Pneumologia, Hospital Clínic IDIBAPS-CIBERES, Universitat de Barcelona, Villarroel, 170, 08036 Barcelona, Spain, Tel [phone], Email rororo@ 123456clinic.ub.es

Article

Publisher ID: copd-11-1973

DOI: 10.2147/COPD.S106142

PMC ID: 5001655

Copyright statement: © 2016 Rodriguez-Roisin et al. This work is published and licensed by Dove Medical Press Limited

License:

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Categories

Subject: Original Research