Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Comparison for the Effects of Triple Therapy with Salmeterol/Fluticasone Propionate and Tiotropium Bromide versus Individual Components in Patients of Severe COPD Combined with Bronchial Hyperresponsiveness

기관지 과민성이 동반된 중증 만성 폐쇄성 폐질환 환자에 대한 Salmeterol/Fluticasone Propionate와 Tiotropium Bromide 병합 요법과 단독 요법 치료효과 비교

  • Sohn, Ji Youn (Department of Internal Medicine, Chonbuk National University Medical School) ;
  • Kim, So Ri (Department of Internal Medicine, Chonbuk National University Medical School) ;
  • Park, Seoung Ju (Department of Internal Medicine, Chonbuk National University Medical School) ;
  • Lee, Heung Bum (Department of Internal Medicine, Chonbuk National University Medical School) ;
  • Lee, Yong Chul (Department of Internal Medicine, Chonbuk National University Medical School) ;
  • Rhee, Yang Keun (Department of Internal Medicine, Chonbuk National University Medical School)
  • 손지연 (전북대학교 의학전문대학원 내과학교실) ;
  • 김소리 (전북대학교 의학전문대학원 내과학교실) ;
  • 박성주 (전북대학교 의학전문대학원 내과학교실) ;
  • 이흥범 (전북대학교 의학전문대학원 내과학교실) ;
  • 이용철 (전북대학교 의학전문대학원 내과학교실) ;
  • 이양근 (전북대학교 의학전문대학원 내과학교실)
  • Received : 2009.09.12
  • Accepted : 2009.11.20
  • Published : 2009.12.30
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Abstract

Background: A combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) is commonly prescribed for COPD patients but there is little data on their effectiveness, particularly in COPD patients with bronchial hyperresponsiveness. This study compared the spirometric improvement based on the change in $FEV_1$, $FEV_1$/FVC, and IC as well as the clinical outcomes of the therapeutic strategies with SFC and TIO versus the individual components in patients with severe COPD and bronchial hyperresponsiveness. Methods: This study examined the spirometric data and clinical outcomes of 214 patients with COPD and hyperresponsiveness, who were divided into three groups according to the therapeutic regimen (TIO only, SFC only, and a triple therapy regimen). Results: All regimen groups showed early improvement in the $FEV_1$ and IC (at 3- and 6 months after treatment). However, long-term beneficial effects were observed only in the SFC group (at 24 months after treatment). However, these beneficial effects decreased after a 36-month follow up. In all spirometric results, the 12-, 24-, and 36-months data showed a similar degree of improvement in the three groups. The triple therapy group showed higher St. George's Respiratory Questionnaire scores and lower acute exacerbations and hospitalization. Conclusion: SFC can be a more important component in the pharmacological treatment of severe COPD patients with hyperresponsiveness than TIO, particularly in the spirometric and clinical outcomes.

Keywords

References

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