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Journal papers
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Responses to inhaled long-acting beta-agonist and corticosteroid according to COPD subtype
Title
Responses to inhaled long-acting beta-agonist and corticosteroid according to COPD subtype
Authors
Lee J.-H.
;
Lee Y.K.
;
Kim E.-K.
;
Kim T.-H.
;
Huh J.W.
;
Kim W.J.
;
Lee J.H.
;
Lee S.-M.
;
Lee S.
;
Lim S.Y.
;
Shin T.R.
;
Yoon H.I.
;
Sheen S.S.
;
Kim N.
;
Seo J.B.
;
Oh Y.-M.
;
Lee S.D.
Ewha Authors
이진화
SCOPUS Author ID
이진화
Issue Date
2010
Journal Title
Respiratory Medicine
ISSN
0954-6111
Citation
Respiratory Medicine vol. 104, no. 4, pp. 542 - 549
Indexed
SCI; SCIE; SCOPUS
Document Type
Article
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 FEV1 more than 45% of the predicted value. The obstruction-dominant subtype had an emphysema index ≤ 20% and FEV1 ≤ 45%, the mild-mixed subtype had an emphysema index ≤ 20% and FEV1 > 45%, and the severe-mixed subtype had an emphysema index > 20% and FEV1 ≤ 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 FEV1 increase and more marked dyspnea improvement than did the emphysema-dominant subgroup. The mixed-subtype patients (both subgroups) also showed significant improvement in FEV1 compared with the emphysema-dominant subgroup. Emphysema-dominant subtype patients showed no improvement in FEV1 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. © 2009 Elsevier Ltd. All rights reserved.
DOI
10.1016/j.rmed.2009.10.024
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