Correlation between Bronchodilator Responsiveness and Quality of Life in Chronic Obstructive Pulmonary Disease

Omata, Masatoshi; Wakabayashi, Ritsuko; Kudoh, Shoji; Kida, Kenji

doi:10.2332/allergolint.o-06-431

Cited by 12 publications

(9 citation statements)

References 39 publications

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“…Although these observations have to be verified in a wider range of COPD patients, including women, we believe that this parameter is important and should be included in the daily practice of pulmonary medicine and promoted by GOLD. 11 hand, in stable COPD patients, Omata et al [37] showed a cross-sectional relationship between BD reversibility and the respective items of health-related quality of life (HRQoL) and activities of daily living. Interestingly, the acute FVC response to BD was significantly correlated with numerous HRQoL items, which was not the case for the FEV 1 response.…”

Section: Discussionmentioning

confidence: 99%

The forgotten message from gold: FVC is a primary clinical outcome measure of bronchodilator reversibility in COPD

Saad

Préfaut

Tabka

et al. 2008

Pulmonary Pharmacology & Therapeutics

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Section: Discussionmentioning

confidence: 99%

The forgotten message from gold: FVC is a primary clinical outcome measure of bronchodilator reversibility in COPD

Saad

Préfaut

Tabka

et al. 2008

Pulmonary Pharmacology & Therapeutics

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“…Several studies have demonstrated a significant relationship between poor lung function and worsened health and economic outcomes in patients with COPD [2-13], but few have investigated whether changes in lung function associated with an intervention are correlated with changes in such endpoints [12-15]. There is good evidence that declining lung function leads to worsened patient outcomes, but a surprising lack of evidence that improvements in lung function are correlated with improvements in symptomatic outcomes.…”

Section: Introductionmentioning

confidence: 99%

Correlating changes in lung function with patient outcomes in chronic obstructive pulmonary disease: a pooled analysis

et al. 2011

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BackgroundRelationships between improvements in lung function and other clinical outcomes in chronic obstructive pulmonary disease (COPD) are not documented extensively. We examined whether changes in trough forced expiratory volume in 1 second (FEV1) are correlated with changes in patient-reported outcomes.MethodsPooled data from three indacaterol studies (n = 3313) were analysed. Means and responder rates for outcomes including change from baseline in Transition Dyspnoea Index (TDI), St. George's Respiratory Questionnaire (SGRQ) scores (at 12, 26 and 52 weeks), and COPD exacerbation frequency (rate/year) were tabulated across categories of ΔFEV1. Also, generalised linear modelling was performed adjusting for covariates such as baseline severity and inhaled corticosteroid use.ResultsWith increasing positive ΔFEV1, TDI and ΔSGRQ improved at all timepoints, exacerbation rate over the study duration declined (P < 0.001). Individual-level correlations were 0.03-0.18, but cohort-level correlations were 0.79-0.95. At 26 weeks, a 100 ml increase in FEV1 was associated with improved TDI (0.46 units), ΔSGRQ (1.3-1.9 points) and exacerbation rate (12% decrease). Overall, adjustments for baseline covariates had little impact on the relationship between ΔFEV1 and outcomes.ConclusionsThese results suggest that larger improvements in FEV1 are likely to be associated with larger patient-reported benefits across a range of clinical outcomes.Trial RegistrationClinicalTrials.gov NCT00393458, NCT00463567, and NCT00624286

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“…The role of lung function, and of volume and flow reversibility in predicting disease progression of COPD (e.g. rate of lung function; health status decline, and rate of exacerbations) has been already clarified [Serviddio et al 2006;Calverley et al 2003]: obviously, an improved response to bronchodilators is presumed to impact positively in COPD patients in terms of daily symptoms and quality of life [Omata et al 2007]. …”

Section: Original Researchmentioning

confidence: 99%

Erdosteine enhances airway response to salbutamol in patients with mild-to-moderate COPD

Negro¹,

M²,

Trevisan³

et al. 2008

Ther Adv Respir Dis

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Abstract:Background: Oxidative stress is presumed to impair -adenoceptor function and airway patency. Erdosteine (E), a mucomodulatory compound, has shown important antioxidant properties. Methods:The objective was to assess the effect of antioxidant interventions on short-term airway response to salbutamol in non-reversible mild-to-moderate COPD patients. Thirty COPD patients (GOLD class 1-2), current smoker (!10 pack/year), randomly received E 300 mg, N-acetylcysteine (NAC) 600 mg, or placebo, twice daily for ten days. Reversibility to salbutamol 200 mg was tested in baseline, after four and ten days of each treatment. ROS and 8-isoprostane blood levels were measured on the same days. Between-treatment comparison was performed by ANOVA and t-test or Wilcoxon test, and p50.05 assumed. E enhanced FEV1 reversibility after four and ten days significantly (þ5.1% and þ5.0%; both p50.01 vs. placebo), while NAC only showed a transient effect at day 4 (þ3.0%, p50.05), but not at day 10 (þ1.3%, p ¼ ns).Results: E and NAC caused significant drops in ROS blood levels after four and ten days (p50.001 and p50.0001 vs. placebo). In contrast to NAC, E lowered 8-isoprostane levels substantially for ten days (p ¼ 0.017 and p ¼ 0.0004 vs. placebo, respectively). Only E restored significantly short-term reversibility in COPD patients previously unresponsive to 2 -adrenergics. Conclusions: This effect seems more related to the peculiar protection against lipid peroxidation rather than to the scavenging activity, which proves equal to that of NAC. E provides a sort of indirect bronchodilation through 're-sensitisation' of 2 -adrenoceptors. Once confirmed in further controlled studies, it may be useful in long-term treatment of COPD.

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Correlation between Bronchodilator Responsiveness and Quality of Life in Chronic Obstructive Pulmonary Disease

Abstract: Those who have FVC that respond to bronchodilator at rest might result in an improvement of HRQoL after treatment.

Cited by 12 publications

References 39 publications

The forgotten message from gold: FVC is a primary clinical outcome measure of bronchodilator reversibility in COPD

The forgotten message from gold: FVC is a primary clinical outcome measure of bronchodilator reversibility in COPD

Correlating changes in lung function with patient outcomes in chronic obstructive pulmonary disease: a pooled analysis

Erdosteine enhances airway response to salbutamol in patients with mild-to-moderate COPD

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