<p>Bronchodilators for hyperinflation in COPD associated with biomass smoke: clinical trial</p>

Abstract

Introduction The efficacy of long-acting bronchodilators for COPD associated with biomass (BE-COPD) has not been properly evaluated. Objective To determine the acute effect of indacaterol (IND) 150 μg q.d and tiotropium (TIO) 18 μg q.d. on lung hyperinflation, walking distance (WD) and dyspnea during the six-minute walking test (6MWT) in moderate BE-COPD at 30, 60 and 240 mins post-drug administration. Design Randomized, controlled, open-level, crossover noninferiority clinical trial. Forty-two women with BE-COPD were randomly assigned to a bronchodilator sequence: IND–TIO or vice versa. Results There were statistically significant changes over time in inspiratory capacity (IC) ( p <0.0001), FEV 1 ( p <0.0001) and FVC ( p <0.0001) when IND was used. When TIO was administered, an increase over all time periods was observed only for FEV 1 ( p <0.0001) and FVC ( p <0.0001), whereas for IC an increase was observed only at 30 mins and 24 hrs after TIO administration. We did not find clinically significant increases in WD and dyspnea after the administration of both bronchodilators. Conclusion Both IND and TIO showed significant and fast onset improvement in hyperinflation. Therefore, either of them may be recommended as a first line of treatment for COPD associated with BE-COPD.

Influence of Achalasia on the Spirometry Flow–Volume Curve and Peak Expiratory Flow

“…Patients in our study who had a flattened expiratory curve had a reduction in PEF (less than 80% predicted values). A study by Kossoyvaki and colleagues defined the possibility of monitoring patients with relapsed benign tracheal stenosis with PEF [27,28]. They showed great results.…”

Chronic Obstructive Pulmonary Disease Endotypes in Low- and Middle-Income Country Settings: Precision Medicine for All

“…There are a number of ongoing trials related to prevention of lung injury and treatment of symptomatic COPD, although many are preliminary. Ramirez-Venegas and colleagues examined the efficacy of tiotropium and indacaterol among those with biomass-associated COPD and found improvements in FEV 1 and FVC ( 19 ). An ongoing trial in Uganda (NCT03984188) aims to assess the clinical and cost effectiveness of low-dose theophylline for the management of biomass-associated COPD.…”