FEV1 reversibility does not adequately predict effect of formoterol via Aerolizer® in chronic obstructive pulmonary disease

Muir, Jean-François; Benhamou, D.; Cuvelier, A.; Gros, V. Le; Overend, Tim; Till, Denise; Cioppa, Giovanni Della; Kottakis, John

doi:10.1111/j.1368-5031.2004.00164.x

Cited by 8 publications

(5 citation statements)

References 33 publications

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“…This supports previous assertions (reviewed by Mahler) 2 that a single reversibility test is not predictive of long-term outcomes with b 2 -agonists in patients with COPD; indicating that long-term treatment with formoterol may be equally effective in patients with low or high reversibility. Indeed, Muir et al 22 conclude that formoterol is effective in patients with COPD irrespective of their response to reversibility testing.…”

Section: Discussionmentioning

confidence: 99%

Formoterol for maintenance and as-needed treatment of chronic obstructive pulmonary disease

Campbell

Eliraz

Johansson

et al. 2005

Respiratory Medicine

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Formoterol is a long-acting beta2-agonist with a rapid onset of effect in patients with chronic obstructive pulmonary disease (COPD), making it potentially suitable for both maintenance and as-needed bronchodilator treatment. To evaluate the efficacy and tolerability of maintenance formoterol in patients with COPD and to compare the effects of additional formoterol as needed with terbutaline. In this 6-month, double-blind study, 657 patients with COPD (40 years, forced expiratory volume in 1s [FEV1] 40-70% predicted normal) were randomized to formoterol 9 microg twice daily (bid) plus terbutaline 0.5 mg as needed (FORM bid), formoterol 9 microg bid plus formoterol 4.5 microg as needed (FORM bid+prn), or placebo bid plus terbutaline 0.5 mg as needed (placebo), all administered via Turbuhaler. Primary efficacy variables were FEV1 and the sum of breathlessness and chest tightness scores combined symptom score. Formoterol significantly (P<0.01) increased FEV(1) compared with placebo: FORM bid 6.5% (95% CI: 2.5, 10.7%); FORM bid+prn 11.8% (95% CI: 7.7, 16.2%). Combined symptom score decreased significantly in both formoterol groups compared with placebo: FORM bid -0.27 (95% CI: -0.49, -0.06; P=0.012); FORM bid+prn -0.32 (95% CI: -0.53, -0.11; P=0.0026). Similar significant (P<0.05) improvements were seen in both formoterol groups for morning peak expiratory flow, cough and sleep scores, and reliever use. In this study, formoterol 9 microg bid via Turbuhaler as maintenance therapy, with either formoterol or terbutaline as rescue medication, provided sustained improvements in lung function and COPD symptoms. Both formoterol regimens were well tolerated with no differences in adverse events or electrocardiogram profiles.

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Section: Discussionmentioning

confidence: 99%

Formoterol for maintenance and as-needed treatment of chronic obstructive pulmonary disease

Campbell

Eliraz

Johansson

et al. 2005

Respiratory Medicine

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“…[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] Of the 24 publications that met the inclusion criteria for this systematic review (see Table 1), 16 compared tiotropium with placebo, [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] seven compared tiotropium with an active comparator, [66][67][68][69][70][71][72] and one compared tiotropium with both placebo and an active comparator. 73 The QoL outcomes reported in the 24 included publications were mostly SGRQ and/or TDI (Tables 2 and 3).…”

Section: Summary Of Search Findingsmentioning

confidence: 99%

Effect of tiotropium on quality of life in COPD: a systematic review

Kaplan¹

2010

Primary Care Respiratory Journal

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“…Similar results were obtained in a recent study in which little or no reversibility in bronchodilator testing was found not to be a good predictor of response to formoterol in COPD. (6) Therefore, COPD patients presenting a poor response to short-acting β 2 -agonists might present significant reversibility to formoterol, with considerable improvement in lung function and relief of symptoms. (4,6,24) Functional changes can be seen for weeks after the baseline testing and might be associated with several variables involved in the therapeutic efficacy of the drug.…”

Section: Discussionmentioning

confidence: 99%

“…(6) Therefore, COPD patients presenting a poor response to short-acting β 2 -agonists might present significant reversibility to formoterol, with considerable improvement in lung function and relief of symptoms. (4,6,24) Functional changes can be seen for weeks after the baseline testing and might be associated with several variables involved in the therapeutic efficacy of the drug. (23,24) In a study involving 20 patients with partially reversible COPD and similar to the present study in design (formoterol and a placebo were compared), a significant response was observed even within 10 or 20 min after formoterol administration.…”

Section: Discussionmentioning

confidence: 99%

“…(4) In clinical practice, patients report a subjective improvement of symptoms after the use of formoterol, (5) although such improvements are not always confirmed through the bronchodilator reversibility testing commonly in use. (6) This failure to demonstrate an effect, as defined by measuring forced expiratory volume in one second (FEV 1 ), might result from an early collapse of the airways, which can lead to the underestimation of the bronchodilator effect in the more peripheral airways, where resistance is more marked in COPDs. (7) Recent studies focusing on variables other than FEV 1 to investigate the immediate effect of formoterol as a bronchodilator in COPD, including volume analysis, have shown a good correlation between formoterol administration and the relief of symptoms, dyspnea in particular.…”

Section: Introductionmentioning

confidence: 99%

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Resposta broncodilatadora imediata ao formoterol em doença pulmonar obstrutiva crônica com pouca reversibilidade

et al. 2008

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Objective: To evaluate, using pulmonary function tests, the effectiveness of formoterol as a bronchodilator at 30 min after its administration in patients with poorly reversible COPD. Methods: A prospective study including 40 COPD patients not responding to the short-acting bronchodilator used in the spirometric test-variation of less than 200 mL and less than 7% of predicted in forced expiratory volume in one second (FEV 1 ). All patients were classified as having stage II, III, or IV COPD (Brazilian Thoracic Society/Global Initiative for Chronic Obstructive Lung Disease) and presented FEV 1 ≤ 70% of predicted value. The patients were randomized into two groups of 20, with similar clinical characteristics, receiving, via a dry powder inhaler, either formoterol or a placebo. The pulmonary function testing (plethysmography) was repeated at 30 min after formoterol or placebo administration. Results: In the formoterol group, the mean values obtained for FEV 1 , inspiratory capacity, and forced vital capacity were significantly greater than those obtained in the placebo group (p = 0.00065, p = 0.05, and p = 0.017, respectively), whereas that obtained for airway resistance was significantly lower (p = 0.010). Less pronounced differences were observed for residual volume, vital capacity and specific airway conductance, which were lower, higher and higher, respectively, in the formoterol group. Conclusions: In COPD patients not responding to the short-acting bronchodilator used in the spirometric test, formoterol promoted significant improvement in lung function at 30 min after of administration. Further studies are required to confirm whether formoterol can also be used as a medication for immediate relief of symptoms in COPD.Keywords: Chronic obstructive pulmonary disease; Respiratory function tests; Bronchodilator agents. ResumoObjetivo: Avaliar, por meio de provas de função pulmonar, a eficácia broncodilatadora do formoterol após 30 min de sua administração em portadores de doença pulmonar obstrutiva crônica (DPOC) com pouca reversibilidade. Métodos: Estudo prospectivo incluindo 40 pacientes portadores de DPOC com resposta negativa ao broncodilatador de curta duração utilizado no teste espirométrico-variação menor que 200 mL e 7% do previsto do volume expiratório forçado no primeiro segundo (VEF 1 ). Os pacientes encontravam-se nos estágios II, III ou IV da DPOC (Sociedade Brasileira de Pneumologia e Tisiologia/Global Initiative for Chronic Obstructive Lung Disease) e apresentavam VEF 1 ≤ 70% do previsto. Foram randomizados em dois grupos de 20, com características clínicas semelhantes, e cada grupo recebeu formoterol ou placebo por meio de inalador de pó seco. As provas de função pulmonar (por pletismografia) foram repetidas após 30 min da administração de formoterol ou placebo. Resultados: Observaram-se aumento significativo de VEF 1 (p = 0,00065), capacidade inspiratória (p = 0,05) e capacidade vital forçada (p = 0,017) e redução significativa da resistência das vias aéreas (p = 0,010) no grupo formotero...

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FEV1 reversibility does not adequately predict effect of formoterol via Aerolizer® in chronic obstructive pulmonary disease

Cited by 8 publications

References 33 publications

Formoterol for maintenance and as-needed treatment of chronic obstructive pulmonary disease

Formoterol for maintenance and as-needed treatment of chronic obstructive pulmonary disease

Effect of tiotropium on quality of life in COPD: a systematic review

Resposta broncodilatadora imediata ao formoterol em doença pulmonar obstrutiva crônica com pouca reversibilidade

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