2021년 Vol.38 No.02
Background : According to the treatment guidelines for Chronic Obstructive Pulmonary Disease (COPD), long-acting β2 agonists (LABA) and long-acting muscarinic antagonists (LAMA) are recommended. Addition of inhaled corticosteroid (ICS) is more effective in reducing acute exacerbations in patients with exacerbations and moderate to very severe COPD, but some studies have shown that it could increase the risk of pneumonia. Therefore, this study was conducted to evaluate the efficacy and safety of LABA/LAMA versus LABA/LAMA/ICS.
Methods : Between January 2016 and June 2017, medical records of patients with moderate to severe COPD who visited the Department of Pulmonology in one hospital and started using LABA/LAMA (dual therapy) or LABA/LAMA/ICS (triple therapy) were reviewed retrospectively. The efficacy between in the two groups was evaluated as the number of acute exacerbations and change in pulmonary function. We also analyzed adverse drug reactions including pneumonia.
Results : A total of 53 patients received dual therapy and 47 patients received triple therapy. The rate of acute exacerbations was reduced and change in FEV1 (Forced expiratory volume for 1 second) was improved in each group, but there was no difference between the two groups. Pneumonia occurred in 7.5% of patients receiving dual therapy versus 4.3% of patients receiving triple therapy, and other adverse drug reactions occurred in 11.3% of patients receiving dual therapy versus 4.3% of patients receiving triple therapy.
Conclusion : Reduction in the rate of acute exacerbations in the triple therapy group was not significantly better than that in the dual therapy group, but adverse drug reactions, including pneumonia also did not show a difference between the two groups.