Outcome of Inhaler Withdrawal in Patients Receiving Triple Therapy for COPDopen access
- Authors
- Kim, Sae Ahm; Lee, Ji-Hyun; Kim, Eun-Kyung; Kim, Tae-Hyung; Kim, Woo Jin; Lee, Jin Hwa; Yoon, Ho Il; Baek, Seunghee; Lee, Jae Seung; Oh, Yeon-Mok; Lee, Sang-Do
- Issue Date
- Jan-2016
- Publisher
- TAEHAN KYORHAEK HYOPHOE-KOREAN ACAD TUBERCULOSIS & RESPIRATORY DISEASES
- Keywords
- Pulmonary Disease; Chronic Obstructive
- Citation
- TUBERCULOSIS AND RESPIRATORY DISEASES, v.79, no.1, pp.22 - 30
- Indexed
- SCOPUS
KCI
- Journal Title
- TUBERCULOSIS AND RESPIRATORY DISEASES
- Volume
- 79
- Number
- 1
- Start Page
- 22
- End Page
- 30
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/5148
- DOI
- 10.4046/trd.2016.79.1.22
- ISSN
- 1738-3536
- 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 beta 2-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 step-down 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 step-down 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.
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