Original Article
Effectiveness and safety between LAMA+ LABA and ICS+ LABA in patients with moderate-to-severe chronic obstructive pulmonary disease: A randomized control study
Sheng Weili, Liu Xuejiao, He Ning, Chang Jinlai, Yin Fengxian
Published 2022-07-20
Cite as Int J Respir, 2022, 42(14): 1041-1046. DOI: 10.3760/cma.j.cn131368-20211217-00922
Abstract
ObjectiveTo compare the benefits and harms of long-acting muscarinic antagonist (LAMA)+ long-acting beta-agonist (LABA) and inhaled glucocorticoids (ICS)+ LABA in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) with an eosinophilic count 100-300 cells/μl.
MethodsThis was a prospective cohort study.A total of 172 patients with moderate-to-severe COPD were followed up in the Department of Respiratory and Critical Care Medicine clinic of Daxing District People′s Hospital of Beijing from January 2021 to November 2021.They were randomly divided into two groups: 88 cases in LAMA+ LABA group and 84 cases in ICS+ LABA group.The effectiveness of LAMA+ LABA or ICS+ LABA maintenance treatment were evaluated, and effectiveness end points were the changes from baseline in trough FEV1, transition dyspnea index (TDI) total scores, COPD assessment test (CAT) scores and exacerbations at Week 26.
ResultsLAMA+ LABA group showed superior improvement in trough FEV1 at Week 26 compared with ICS+ LABA group [(1.87±0.75) L vs (1.66±0.60) L], (t=1.98, P=0.049); LAMA+ LABA group demonstrated significantly superior improvement in TDI total scores at Week 26 compared with ICS+ LABA group [(1.94±0.26) units vs (0.82±0.17) units], (t=32.98, P<0.001); LAMA+ LABA group revealed significantly superior improvement in total CAT score at Week 26 compared with ICS+ LABA group [(10.3±4.7) vs (16.5±5.2)], (t=8.21, P<0.001). There were no patient deaths during the study, and there were no differences in pneumonia or severe exacerbations between both treatment groups (both P>0.05).
ConclusionsLAMA+ LABA was safe and showed superior clinically significant improvements in lung function and patient-related outcomes in patients with moderate-to-severe COPD with an eosinophilic count 100-300 cells/μl, which will provide certain reference for clinical treatment.
Key words:
Pulmonary disease, chronic obstructive; Blood eosinophil; Lung function; COPD assessment test; Transition dyspnea index
Contributor Information
Sheng Weili
Department of Respiratory and Critical Care Medicine, Daxing District People′s Hospital of Beijing, Beijing 102600, China
Liu Xuejiao
Department of Respiratory and Critical Care Medicine, Daxing District People′s Hospital of Beijing, Beijing 102600, China
He Ning
Department of Respiratory and Critical Care Medicine, Daxing District People′s Hospital of Beijing, Beijing 102600, China
Chang Jinlai
Department of Respiratory and Critical Care Medicine, Daxing District People′s Hospital of Beijing, Beijing 102600, China
Yin Fengxian
Department of Respiratory and Critical Care Medicine, Daxing District People′s Hospital of Beijing, Beijing 102600, China
