RT Journal Article
SR Electronic
T1 Double blind, placebo controlled crossover study in COPD patients to assess the acute effect of budesonide/formoterol using multi-slice CT and lung function tests
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00725-2011
DO 10.1183/09031936.00072511
A1 L.A. De Backer
A1 W. Vos
A1 J. De Backer
A1 C. Van Holsbeke
A1 S. Vinchurkar
A1 W. De Backer
YR 2012
UL http://erj.ersjournals.com/content/early/2011/12/16/09031936.00072511.abstract
AB The GOLD classification of COPD does not always matches with other clinical disease descriptors such as exacerbation frequency and quality of life indicating that FEV1 is not a perfect descriptor of the disease. The aim of this study was to see whether changes in airway geometry after inhalation of the most commonly used inhalation therapy in severe COPD can more adequately be described with an imaged based approach then with spirometry. A total of 10 COPD GOLD III patients was assessed in a double blind cross over study. Airway volumes were analysed using segmentation of the MSCT images, airway resistance was determined using computational fluid dynamics (CFD). Results showed that distal airway volume significantly increased (p=0.011) in patients four hours after receiving budesonide/formoterol combination from 9.6±4.67cm3 to 10.14±4.81cm3. Also CFD-based airway resistance significantly decreased (p=0.047) from 0.051±0.021 kPas·l−1 to 0.043±0.019 kPas·l−1. None of the lung function parameters showed a significant change. Only FRC showed a trend to decline (p=0.056). Only the image-based parameters were able to predict the visit at which the combination product was administered. This study showed that imaging is a sensitive, complementary tool to describe changes in airway structure.