Abstract

Exercise intolerance is a major feature in patients with Chronic Obstructive Pulmonary Disease (COPD). Bronchodilators increase endurance time (ET) and reduce dynamic hyperinflation (DH). We evaluated whether a single-dose of salbutamol/ipratropium + flunisolide (BD+ICS), added on top of the regular treatment, may improve ET in COPD patients. In a single-blind randomized crossover pilot trial, nebulised BD+ICS or placebo (PL) was administered 30 min before a constant load cardiopulmonary test, in 22 moderate-to-severe COPD patients (FEV₁: 53.9% pred). ET was the primary outcome measured. BD+ICS did not improve ET or VO₂ peak with respect to PL. BD+ICS increased pre-test FEV₁ and pre-test Inspiratory Capacity but did not modify DH. In a retrospective analysis, patients were divided in Improvers (N=11) and Non-Improvers (N=11) according to the difference in ET between BD+ICS and PL (> 25 s). Improvers had a worst BODE index, a higher static hyperinflation and poorer Vd/Vt ratio at peak of exercise with respect to Non-Improvers. Improvers only had a significant increase from BD+ICS on pre-test FEV₁ and IC. In conclusion, although a single-dose BD+ICS did not improve ET in COPD patients under regular treatment, a subgroup of more severe patients may have some benefit from that.

Links

Publisher Full Text

Authors

Vagaggini B, Nieri D, Malagrinò L, Antonelli S, De Cusatis G, De Simone C, Costa F, Paggiaro PL

Institution

Cardio-Thoracic and Vascular Department, Section of Pneumology, University of Pisa, Italy. b.vagaggini@ao-pisa.toscana.it

Source

Pulmonary pharmacology & therapeutics 24:1 2011 Feb pg 49-54

MeSH

Aged
Bronchodilator Agents
Cross-Over Studies
Exercise Tolerance
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Oxygen Consumption
Pulmonary Disease, Chronic Obstructive
Single-Blind Method

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20970517