Abstract
Introduction: The airway reversibility test (ART) is performed to diagnose obstructive airway disease (OAD) such as asthma and COPD. The ART revealed negative results in some asthma patients. It can be made insufficient treatment (Tx) for those patients.
Objectives: We reviewed the patients' data to evaluate the characteristics of the patients who have marked improvement of spirometry (SPM) after regular Tx among patients with SPM below COPD stage II by GOLD guideline.
Method: We reviewed SPM records of 1072 patients who performed ART to evaluate dyspnea from 1st September 2009 to 30th August 2010. Finally we reviewed the pre and post-Tx SPM data and characteristics of 121 patients who have pre-bronchodilator (BD) FEV1/FVC<70%, FEV1 <80%, and negative for ART.
Results: Twenty four patients (19.8%) showed improved FEV1 >80% after regular Tx with ICS and/or tiotropium (group 1). Four patients showed improvement of FEV1/FVC >70% and FEV1 > 80% (group 2). The mean increments of FEV1 are 0.47 L and 0.61 L in group 1 and 2. The increment of FEV1 after Tx slightly correlated with initial post-BD FEV1 change in ART (R=0.213, p=0.019). But, the post-BD FEV1 change (%) was not different between group 1 and non-responder group (5.29±6.35 vs. 6.71±5.41, p = 0.33).
Conclusion: The results of this study show about 20% of patients with SPM fitted in moderate COPD had FEV1 improvement >80% after Tx. But we could not find specific characteristics in those patients. Collectively, physicians may consider active initial Tx including ICS when managing patients of OAD even though initial BD response is minimal. And further study to find the predictor of favorable Tx outcome will be needed.
- © 2011 ERS