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Outcome of Inhaler Withdrawal in Patients eceiving Triple Therapy for COPD

Title
Outcome of Inhaler Withdrawal in Patients eceiving Triple Therapy for COPD
Author
김태형
Keywords
Pulmonary Disease; Chronic Obstructive
Issue Date
2016-01
Publisher
Korean National Tuberculosis Association
Citation
Tuberculosis and Respiratory Diseases, v. 79, NO 1, Page. 22-30
Abstract
Background The purpose of this study was to document outcomes following withdrawal of a single inhaler (step-down) in chronic obstructive pulmonary disease (COPD) patients on triple therapy (long-acting muscarinic antagonist and a combination of long-acting β2-agonists and inhaled corticosteroid), which a common treatment strategy in clinical practice. Methods Through a retrospective observational study, COPD patients receiving triple therapy over 2 years (triple group; n=109) were compared with those who had undergone triple therapy for at least 1 year and subsequently, over 9 months, initiated inhaler withdrawal (step-down group, n=39). The index time was defined as the time of withdrawal in the stepdown group and as 1 year after the start of triple therapy in the triple group. Results Lung function at the index time was superior and the previous exacerbation frequency was lower in the stepdown group than in the triple group. Step-down resulted in aggravating disease symptoms, a reduced overall quality of life, decreasing exercise performance, and accelerated forced expiratory volume in 1 second (FEV1) decline (54.7±15.7 mL/yr vs. 10.7±7.1 mL/yr, p=0.007), but there was no observed increase in the frequency of exacerbations. Conclusion Withdrawal of a single inhaler during triple therapy in COPD patients should be conducted with caution as it may impair the exercise capacity and quality of life while accelerating FEV1 decline.
URI
https://synapse.koreamed.org/DOIx.php?id=10.4046/trd.2016.79.1.22http://hdl.handle.net/20.500.11754/30525
ISSN
1738-3536; 2005-6184
DOI
10.4046/trd.2016.79.1.22
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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