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Responses to inhaled long-acting beta-agonist and corticosteroid according to COPD subtype.

Authors
Lee, JH | Lee, YK | Kim, EK | Kim, TH | Huh, JW | Kim, WJ | Lee, SM | Lee, S | Lim, SY | Shin, TR | Yoon, HI | Sheen, SS  | Kim, N | Seo, JB | Oh, YM | Lee, SD
Citation
Respiratory medicine, 104(4). : 542-549, 2010
Journal Title
Respiratory medicine
ISSN
0954-61111532-3064
Abstract
RATIONALE: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disorder in which a number of different pathological processes lead to recognition of patient subgroups that may have individual characteristics and distinct responses to treatment.



OBJECTIVES: We tested the hypothesis that responses of lung function to 3 months of combined inhalation of long-acting beta-agonist and corticosteroid might differ among patients with various COPD subtypes.



METHODS: We classified 165 COPD patients into four subtypes according to the severity of emphysema and airflow obstruction: emphysema-dominant, obstruction-dominant, mild-mixed, and severe-mixed. The emphysema-dominant subtype was defined by an emphysema index on computed tomography of more than 20% and FEV(1) more than 45% of the predicted value. The obstruction-dominant subtype had an emphysema index < or = 20% and FEV(1) < or = 45%, the mild-mixed subtype had an emphysema index < or = 20% and FEV(1) > 45%, and the severe-mixed subtype had an emphysema index > 20% and FEV(1) < or = 45%. Patients were recruited prospectively and treated with 3 months of combined inhalation of long-acting beta-agonist and corticosteroid.



RESULTS: After 3 months of combined inhalation of long-acting beta-agonist and corticosteroid, obstruction-dominant subtype patients showed a greater FEV(1) increase and more marked dyspnea improvement than did the emphysema-dominant subgroup. The mixed-subtype patients (both subgroups) also showed significant improvement in FEV(1) compared with the emphysema-dominant subgroup. Emphysema-dominant subtype patients showed no improvement in FEV(1) or dyspnea after the 3-month treatment period.



CONCLUSION: The responses to 3 months of combined inhalation of long-acting beta-agonist and corticosteroid differed according to COPD subtype.
MeSH

DOI
10.1016/j.rmed.2009.10.024
PMID
19926461
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
Ajou Authors
신, 승수
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