Journal article
Short-term effects of inhalative tiotropium/formoterol/budenoside versus tiotropium/formoterol in patients with newly diagnosed chronic obstructive pulmonary disease requiring surgery for lung cancer: a prospective randomized trial
European journal of cardio-thoracic surgery, Vol.39(6), pp.995-1000
06/2011
DOI: 10.1016/j.ejcts.2010.09.025
PMID: 20970351
Abstract
Abstract
Objective: A new diagnosis of chronic obstructive pulmonary disease (COPD) is often made during the evaluation of patients requiring a surgical intervention for lung cancer. Based on initial impaired lung function, these untreated patients are often considered not fit for lung surgery. There is limited information on the short-term effectiveness of preoperative pharmacologic treatment strategies in patients with newly diagnosed COPD before lung surgery. Methods: A prospective randomized study was conducted comparing 1-week-treatment periods of tiotropium/formoterol/budenoside (GR1) with tiotropium/formoterol (GR2) in conjunction with smoking cessation and chest physiotherapy. No patients had been previously treated for COPD. The primary end point was body plethysmography (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and airway resistance (RAW)) at the end of each treatment period. Secondary end points were improvement of ≥10% in FEV1 (% predicted) and improvement of the severity of COPD after the 1-week treatment, as well as the rate of pulmonary complications after surgery. Results: A total of 46 patients were randomized in GR1 (n = 24) and GR2 (n = 22). Both groups were comparable with regard to age, height, weight, smoking history, baseline body plethysmography (FVC, FEV1, and RAW), and the severity of COPD according to the Global Initiative for Obstructive Lung Disease (GOLD) staging, respectively. However, the short-term effects of the treatment with regard to FEV1 (2.0 l vs 1.7 l; p = 0.031) and increase of FEV1 (0.31 l vs 0.10 l; p = 0.02) were better in GR1. More patients in GR1 had an improvement of ≥10% in FEV1 (p = 0.004) and improvement of the severity of COPD (p = 0.012) after the 1-week treatment. Fewer pulmonary complications (11.1% vs 42.9%, p = 0.04) were observed in GR1 after surgery. Conclusions: Both therapies resulted in an improvement of lung function. There is benefit from adding inhalative budenoside to tiotropium and formoterol in terms of an improvement in FEV1 and the severity of COPD. These beneficial results might lead to less pulmonary complications in the postoperative period.
Details
- Title: Subtitle
- Short-term effects of inhalative tiotropium/formoterol/budenoside versus tiotropium/formoterol in patients with newly diagnosed chronic obstructive pulmonary disease requiring surgery for lung cancer: a prospective randomized trial
- Creators
- Servet Bölükbas - aDepartment of Thoracic Surgery, Dr.-Horst-Schmidt-Klinik, Wiesbaden, GermanyMichael Eberlein - aDepartment of Thoracic Surgery, Dr.-Horst-Schmidt-Klinik, Wiesbaden, GermanyJennifer Eckhoff - aDepartment of Thoracic Surgery, Dr.-Horst-Schmidt-Klinik, Wiesbaden, GermanyJoachim Schirren - aDepartment of Thoracic Surgery, Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany
- Resource Type
- Journal article
- Publication Details
- European journal of cardio-thoracic surgery, Vol.39(6), pp.995-1000
- Publisher
- Elsevier Science B.V
- DOI
- 10.1016/j.ejcts.2010.09.025
- PMID
- 20970351
- ISSN
- 1010-7940
- eISSN
- 1873-734X
- Language
- English
- Date published
- 06/2011
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094658002771
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