Outcome of Inhaler Withdrawal in Patients Receiving Triple Therapy for COPD.
- Author:
Sae Ahm KIM
1
;
Ji Hyun LEE
;
Eun Kyung KIM
;
Tae Hyung KIM
;
Woo Jin KIM
;
Jin Hwa LEE
;
Ho Il YOON
;
Seunghee BAEK
;
Jae Seung LEE
;
Yeon Mok OH
;
Sang Do LEE
Author Information
- Publication Type:Original Article
- Keywords: Pulmonary Disease; Chronic Obstructive
- MeSH: Forced Expiratory Volume; Humans; Lung; Lung Diseases; Nebulizers and Vaporizers*; Observational Study; Pulmonary Disease, Chronic Obstructive*; Quality of Life; Retrospective Studies
- From:Tuberculosis and Respiratory Diseases 2016;79(1):22-30
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: The purpose of this study was to document outcomes following withdrawal of a single inhaler (step-down) in chronic obstructive pulmonary disease (COPD) patients on triple therapy (long-acting muscarinic antagonist and a combination of long-acting beta2-agonists and inhaled corticosteroid), which a common treatment strategy in clinical practice. METHODS: Through a retrospective observational study, COPD patients receiving triple therapy over 2 years (triple group; n=109) were compared with those who had undergone triple therapy for at least 1 year and subsequently, over 9 months, initiated inhaler withdrawal (step-down group, n=39). The index time was defined as the time of withdrawal in the stepdown group and as 1 year after the start of triple therapy in the triple group. RESULTS: Lung function at the index time was superior and the previous exacerbation frequency was lower in the stepdown group than in the triple group. Step-down resulted in aggravating disease symptoms, a reduced overall quality of life, decreasing exercise performance, and accelerated forced expiratory volume in 1 second (FEV1) decline (54.7+/-15.7 mL/yr vs. 10.7+/-7.1 mL/yr, p=0.007), but there was no observed increase in the frequency of exacerbations. CONCLUSION: Withdrawal of a single inhaler during triple therapy in COPD patients should be conducted with caution as it may impair the exercise capacity and quality of life while accelerating FEV1 decline.
