Efficacy of tiotropium and olodaterol combination therapy on dynamic lung hyperinflation evaluated by hyperventilation in COPD: an open-label, comparative before and after treatment study
Efficacy of tiotropium and olodaterol combination therapy on dynamic lung hyperinflation evaluated by hyperventilation in COPD: an open-label, comparative before and after treatment study
复制标题
DOI：
10.2147/copd.s201106
复制
发表时间：
2019-01-01
影响因子：
2.8
通讯作者：
Fujimoto, Keisaku
中科院分区：
文献类型：
--
作者：
Kawachi, Shohei;Fujimoto, Keisaku
背景：据报道，节拍器节奏增量过度通气 (MPIH) 后的动态肺过度充气 (DLH) 可用于评估慢性阻塞性肺疾病 (COPD) 患者的病理生理损伤，而噻托溴铵和奥达特罗对 MPIH 后 DLH 的影响尚未报道。方法：治疗包括给予噻托溴铵/奥达特罗 5/5 μg 吸入溶液（每次启动 2.5/2.5 微克）使用软雾吸入器，每天一次。我们比较了治疗 8 周之前和之后的结果。主要结局被定义为 MPIH（DLH 的一个指标）相对于休息时吸气量 (IC) 的下降。次要结果是 COPD 评估测试 (CAT)、1 秒用力呼气量 (FEV1) 和 6 分钟步行距离 (6MWD)。此外，我们还调查了 DLH 和 FEV1、6MWD 和呼吸困难的治疗变化之间是否存在相关性。结果：38 名注册患者中有 33 名完成了这项研究。这 33 名患者中的大多数患有轻度至中度 COPD。治疗 8 周后，MPIH 引起的 IC 降低显着降低，平均变化约为 -0.11 至 -0.13 mL（P < 0.05）。此外，CAT 评分、FEV1 和 6MWD 均随治疗而改善（P < 0.05）。 DLH、FEV1、6MWD 或呼吸困难的变化与治疗之间没有显着相关性。结论：本研究结果表明，噻托溴铵和奥达特罗联合用药可有效改善过度通气后的 DLH。
Background: Dynamic lung hyperinflation (DLH) following metronome-paced incremental hyperventilation (MPIH) was reported to be useful for assessment of pathophysiological impairment in patients with chronic obstructive pulmonary disease (COPD), and the effects of tiotropium and olodaterol on DLH following MPIH have not been reported.Methods: Treatment consisted of administration of tiotropium/olodaterol 5/5 mu g inhalation solution (2.5/2.5 mu g per actuation) using a soft-mist inhaler once a day. We compared outcomes before and after 8 weeks of treatment. The primary outcome was defined as a decrease in inspiratory capacity (IC) from rest by MPIH, which is an index of DLH. The secondary outcomes were COPD assessment test (CAT), forced expiratory volume in 1 s (FEV1), and 6-min walking distance (6MWD). In addition, we investigated whether there were correlations between changes with treatment in DLH and FEV1, 6MWD, and dyspnea.Results: Thirty-three of the 38 registered patients completed this study. Most of these 33 patients had mild to moderate COPD. Decreasing IC by MPIH was significantly reduced by treatment for 8 weeks, with a mean change of about -0.11 to -0.13 mL (P < 0.05). In addition, CAT score, FEV1, and 6MWD improved with treatment (P < 0.05). There were no significant correlations between changes in DLH, FEV1, 6MWD, or dyspnea with treatment.Conclusions: The results of this study showed that the combination of tiotropium and olodaterol is effective for improvement of DLH following hyperventilation.