Dataset Information

Bronchodilator reversibility in patients with COPD revisited: short-term reproducibility.

ABSTRACT: Categorization of patients with COPD as reversible or nonreversible to a bronchodilator may change over time. This post hoc analysis aimed to determine if an individual's reversibility, when treated as a continuous variable, could predict his/her future response to two short-acting bronchodilators: albuterol and ipratropium. The analysis was completed using data from a 4-week, randomized, open-label, two-period crossover study (NCT01691482; GSK study DB2114956). Patients received albuterol (doses: UK =4×100 ?g/puff; US =4×90 ?g/puff) followed 1 hour later by ipratropium (4×20 ?g/puff) or vice versa during treatment Period 1. The order of treatments was reversed during Period 2. Predefined efficacy end points included pre- and post-bronchodilator forced expiratory volume in 1 second. The correlation coefficient between bronchodilator response on Days 1 and 10 was investigated, as well as the correlation between treatment response on Day 1 and the mean treatment response on Days 5-10, for each individual patient. Bronchodilator response to albuterol on Day 1 was strongly correlated with that on Day 10 (r=0.64; n=53). The correlation coefficient of bronchodilator treatment response on Day 1 and Days 5-10 was 0.78 (P<0.001; n=53) and 0.76 (P<0.001; n=54) for albuterol and ipratropium, respectively. A single measurement of the initial bronchodilator response to albuterol or ipratropium was, therefore, highly correlated with the subsequent mean bronchodilator response over 5-10 days, demonstrating its potential usefulness for future treatment decisions.

SUBMITTER: Pascoe S

PROVIDER: S-EPMC5010081 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Bronchodilator reversibility in patients with COPD revisited: short-term reproducibility.

Pascoe Steven S Wu Wei W Zhu Chang-Qing CQ Singh Dave D

International journal of chronic obstructive pulmonary disease 20160829

Categorization of patients with COPD as reversible or nonreversible to a bronchodilator may change over time. This post hoc analysis aimed to determine if an individual's reversibility, when treated as a continuous variable, could predict his/her future response to two short-acting bronchodilators: albuterol and ipratropium. The analysis was completed using data from a 4-week, randomized, open-label, two-period crossover study (NCT01691482; GSK study DB2114956). Patients received albuterol (dose ...[more]

PMID: 27621609

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Project description:BackgroundIt is not known whether environmental gamma radiation measured in US cities has detectable adverse health effects. We assessed whether short-term exposure to gamma radiation emitted from ambient air particles [gamma particle activity (PRγ)] is associated with reduced pulmonary function in chronic obstructive pulmonary disease (COPD) patients.ObjectiveWe hypothesize that the inhalation of gamma radiation emitted from ambient air particles may be associated with reduced pulmonary function in individuals with COPD.MethodsIn 125 patients with COPD from Eastern Massachusetts who had up to 4 seasonal one-week assessments of particulate matter ≤2.5 μm (PM2.5), black carbon (BC), and sulfur followed by spirometry. The US EPA continuously monitors ambient gamma (γ) radiation including γ released from radionuclides attached to particulate matter that is recorded as 9 γ-energy spectra classes (i = 3-9) in counts per minute (CPMγ) in the Boston area (USA). We analyzed the associations between ambient and indoor PRγi (up to one week) and pre and post-bronchodilator (BD) forced expiratory volume in 1 s (FEV1) and with forced vital capacity (FVC) using mixed-effects regression models. We estimated indoor PRγi using the ratio of the indoor-to-outdoor sulfur in PM2.5 as a proxy for infiltration of ambient radionuclide-associated particles.ResultsOverall, exposures to ambient and indoor PRγi were associated with a similar decrease in pre- and post-BD FEV1 and FVC. For example, ambient PRγ3 exposure averaged from the day of pulmonary function testing through the previous 3 days [IQR of 55.1 counts per minute (CPMγ)] was associated with a decrease in pre-BD FEV1 of 21.0 ml (95%CI: -38.5 to -3.0 ml; p < 0.01) and pre-BD FVC of 27.5 ml [95% confidence interval (CI): -50.7 to -5.0 ml; p < 0.01] with similar effects adjusting for indoor and outdoor BC and PM2.5.ConclusionOur results show that short-term ambient and indoor exposures to environmental gamma radiation associated with particulate matter are associated with reduced pre- and post-BD pulmonary function in patients with COPD.

Dataset Information

Bronchodilator reversibility in patients with COPD revisited: short-term reproducibility.

Publications

Bronchodilator reversibility in patients with COPD revisited: short-term reproducibility.

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