Computed tomography (CT)-assessed bronchodilation induced by inhaled indacaterol and glycopyrronium/indacaterol in COPD - 28/09/16
Abstract |
Background |
Our previous studies suggested that the site of bronchodilation on CT might differ between inhaled β2 agonists and inhaled anticholinergics in COPD.
Aim |
To assess and compare the bronchodilation effects of inhaled indacaterol and glycopyrronium/indacaterol by airway generation in large airways using CT.
Methods |
CT scans at full inspiration and pulmonary function tests were done in 25 patients with moderate-severe COPD before and 4–5 weeks after daily inhalation of indacaterol and again another 4–5 weeks after inhalation of glycopyrronium/indacaterol. Airway inner luminal area (Ai) at the 3rd (segmental) to 6th generation of 8 selected bronchi, a total of 32 sites, in the right lung was analyzed on 3 occasions. Our proprietary software enables us to select the same airways and the same measurement sites for comparison, with simultaneous confirmation using two screens on the computer.
Results |
The overall increase of Ai (ΔAi, %) averaged at all 32 measurement sites induced by glycopyrronium/indacaterol had a significant correlation with FEV1 improvement (r = 0.7466, p < 0.0001). Both ΔAi, % with indacaterol and ΔAi, % with additional glycopyrronium were significant at the 3rd to 6th generations. Remarkable increases in ΔAi, % were found at the 5th and 6th generations in several subjects with indacaterol or additional glycopyrronium. There were no significant site-differences in the bronchodilation pattern caused by indacaterol and by glycopyrronium/indacaterol at any of the 3rd to 6th generations.
Conclusions |
Additional bronchodilation with glycopyrronium was demonstrated by CT at the 3rd to 6th generations, with no site-specific differences in bronchodilation between indacaterol and glycopyrronium/indacaterol.
This study was registered in the UMIN Clinical Trials Registry (UMIN-CTR) system (www.umin.ac.jp/. ID. UMIN000012043).
Le texte complet de cet article est disponible en PDF.Highlights |
• | We compared CT-assessed bronchodilation fron 3rd to 6th generations between monotherapy and combination therapy in patients with COPD. |
• | Our 3D-CT software enables us to make direct comparison of airway inner luminal area at the same site before and after bronchodilation. |
• | We attempted to examined the novel hypothesis that bronchodilation pattern might differ between monotherapy and combination therapy by airway generations. |
• | Although the study did not prove the hypothesis, we could nevertheless provide further evidence of additional anatomical bronchodilation at 3rd to 6th generation by 3D-CT analysis in response to combination therapy. |
Keywords : Bronchodilation, β2 agonists, Anticholinergics, Pulmonary function tests, Three-dimensional computed tomography
Abbreviation : Ai, BMI, COPD, CT, DLco, FEV1, FRC, FVC, IC, LABA, LAMA, Pi10, RV, SABA, SAMA, SFC, TLC, VA, VC, 3D-CT
Plan
Vol 119
P. 70-77 - octobre 2016 Retour au numéro
Article précédent
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