FEV1 decline in patients with chronic obstructive pulmonary disease: Which treatment option is better for slowing of decline?

Abstract

Rationale: It is now recognised that COPD is a heterogeneous disorder comprising several different phenotypes of which airflow limitation is only one of several characteristics.However, the decline of lung function( by assessing decline of FEV1 and increasing dynamic gas trapping) depends on different treatment regimes which are applied for management of patients with COPD.

Objectives: We undertook this study to determine the FEV1 rate decline in subjects with severe to severe COPD with different treatment regimes.

Methods: Pulmonary function was assessed every three months in 106 patients with severe to very severe COPD patients during a 3-year follow-up period.In all patients were assessed high resolution computed tomography and exacerbation rate in the following period(table1).

Measurements and Main Results: The mean rate of decline was significantly lower for the patients with ICS/LABA +LAMA treatment group than for the patients with LABA+LAMA treatment group(39 vs 72ml,respectively ;P<0.05( table2).Conclusions: In the ICS/LABA+LAMA COPD group the rate of decline FEV1 is slower and shows a more homogeneous rate of decline over time in comparison with LABA +LAMA COPD group.The more rapid decline of lung function and more severe dynamic gas trapping in LABA+LAMA group COPD patients may be explain with more frequent exacerbation rate in the following period.It suggested that anti-inflammatory ICS added to dual long acting bronchodilator therapy is one of best treatment option for patients with severe to very severe COPD.