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Bronchodilator responsiveness in patients with COPD.

D P Tashkin¹, B Celli, M Decramer

¹David Geffen School of Medicine, UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90024, USA. DTashkin@mednet.ucla.edu

The European Respiratory Journal

|February 8, 2008

Summary

Most patients with moderate-to-very-severe chronic obstructive pulmonary disease (COPD) show significant lung function improvement after using inhaled bronchodilators. This study examined acute bronchodilator responsiveness in a large COPD cohort.

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Area of Science:

Pulmonary Medicine
Respiratory Pharmacology

Background:

Acute bronchodilator responsiveness varies in chronic obstructive pulmonary disease (COPD) patients.
Responsiveness depends on bronchodilator type, dose, and timing.
Understanding baseline responsiveness is crucial for COPD management.

Purpose of the Study:

To examine acute bronchodilator responsiveness in a large cohort of moderate-to-very-severe COPD patients.
To assess lung function improvements following administration of ipratropium and salbutamol.
To determine the proportion of COPD patients achieving significant spirometric improvements.

Main Methods:

Analysis of data from 5,756 COPD patients in the UPLIFT trial.
Patients received ipratropium followed by salbutamol after medication washout.
Spirometry performed pre- and 90-minutes post-ipratropium administration.
Defined responsiveness criteria for forced expiratory volume in one second (FEV1).

Main Results:

Mean improvements observed: 229 mL in FEV1 and 407 mL in forced vital capacity (FVC).
53.9% of patients showed >=12% and >=200 mL FEV1 improvement.
65.6% achieved >=15% FEV1 improvement, and 38.6% had >=10% absolute increase in FEV1 % predicted.

Conclusions:

The majority of moderate-to-very-severe COPD patients exhibit meaningful lung function increases.
Inhaled anticholinergic plus sympathomimetic bronchodilators are effective in improving spirometry.
These findings highlight the potential benefits of bronchodilator therapy in COPD.