Blog
About

4
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Bronchodilator reversibility in patients with COPD revisited: short-term reproducibility

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Categorization of patients with COPD as reversible or nonreversible to a bronchodilator may change over time. This post hoc analysis aimed to determine if an individual’s reversibility, when treated as a continuous variable, could predict his/her future response to two short-acting bronchodilators: albuterol and ipratropium. The analysis was completed using data from a 4-week, randomized, open-label, two-period crossover study (NCT01691482; GSK study DB2114956). Patients received albuterol (doses: UK =4×100 μg/puff; US =4×90 μg/puff) followed 1 hour later by ipratropium (4×20 μg/puff) or vice versa during treatment Period 1. The order of treatments was reversed during Period 2. Predefined efficacy end points included pre- and post-bronchodilator forced expiratory volume in 1 second. The correlation coefficient between bronchodilator response on Days 1 and 10 was investigated, as well as the correlation between treatment response on Day 1 and the mean treatment response on Days 5–10, for each individual patient. Bronchodilator response to albuterol on Day 1 was strongly correlated with that on Day 10 ( r=0.64; n=53). The correlation coefficient of bronchodilator treatment response on Day 1 and Days 5–10 was 0.78 ( P<0.001; n=53) and 0.76 ( P<0.001; n=54) for albuterol and ipratropium, respectively. A single measurement of the initial bronchodilator response to albuterol or ipratropium was, therefore, highly correlated with the subsequent mean bronchodilator response over 5–10 days, demonstrating its potential usefulness for future treatment decisions.

          Related collections

          Most cited references 14

          • Record: found
          • Abstract: not found
          • Article: not found

          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

           W MacNee,  ,  B Celli (2004)
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Bronchodilator responsiveness in patients with COPD.

              The degree of acute improvement in spirometric indices after bronchodilator inhalation varies among chronic obstructive pulmonary disease (COPD) patients, and depends upon the type and dose of bronchodilator and the timing of administration. Acute bronchodilator responsiveness at baseline was examined in a large cohort of patients with moderate-to-very-severe COPD participating in the Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial, a 4-yr randomised double-blind trial evaluating the efficacy of 18 mug tiotropium daily in reducing the rate of decline in lung function. After wash-out of respiratory medications, patients received 80 mug ipratropium followed by 400 mug salbutamol. Spirometry was performed before and 90 min following ipratropium administration. The criteria used for forced expiratory volume in one second (FEV(1)) responsiveness were: >or=12% increase over baseline and >or=200 mL; >or=15% increase over baseline; and >or=10% absolute increase in the percentage predicted value. Of the patients, 5,756 had data meeting the criteria for analysis (age 64.5 yrs; 75% male; baseline FEV(1) 1.10 L (39.3% predicted) and forced vital capacity (FVC) 2.63 L). Compared with baseline, mean improvements were 229 mL in FEV(1) and 407 mL in FVC. Of these patients, 53.9% had >or=12% and >or=200 mL improvement in FEV(1), 65.6% had >or=15% improvement in FEV(1), and 38.6% had >or=10% absolute increase in FEV(1) % pred. The majority of patients with moderate-to-very-severe chronic obstructive pulmonary disease demonstrate meaningful increases in lung function following administration of inhaled anticholinergic plus sympathomimetic bronchodilators.
                Bookmark

                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2016
                29 August 2016
                : 11
                : 2035-2040
                Affiliations
                [1 ]GSK, Respiratory Medicines Development Center
                [2 ]PAREXEL International, Research Triangle Park, NC, USA
                [3 ]GSK, Clinical Statistics (Respiratory), Middlesex, UK
                [4 ]Medicines Evaluation Unit, University Hospital of South Manchester NHS Foundation Trust, University of Manchester, Manchester, UK
                Author notes
                Correspondence: Steven Pascoe, GSK, Respiratory Medicines Development Center, 5 Moore Drive, Research Triangle Park, NC 27709-3398, USA, Tel +1 919 491 8859, Email steven.j.pascoe@ 123456gsk.com
                Article
                copd-11-2035
                10.2147/COPD.S108723
                5010081
                © 2016 Pascoe et al. 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 ( http://creativecommons.org/licenses/by-nc/3.0/). 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.

                Categories
                Original Research

                Comments

                Comment on this article