중등증 이상의 COPD 환자에서 흡입용 스테로이드와 지속성 Β2-항진제 복합제제 사용시 용량의 차이가 급성악화에 미치는 영향
The effect of Combination Therapy of Inhaled Corticosteroids and Long-acting Beta2-agonists on Acute Exacerbation in Moderate to Severe COPD Patients
이승현 (고려대학교)
신철 (고려대학교)
이승룡 (고려대학교)
김제형 (고려대학교)
이상엽 (고려대학교)
유세화 (고려대학교)
심재정 (고려대학교)
인광호 (고려대학교)
강경호 (고려대학교)
하은실 (고려대학교)
정진용 (고려대학교)
이경주 (고려대학교)
김세중 (고려대학교)
이은주 (고려대학교)
허규영 (고려대학교)
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Abstract
Background : The role of combination therapy of inhaled corticosteroid (ICS) plus long-acting β2-agonist (LABA) in asthma is well established, but nor much is known about this treatment in COPD. Recent studies have revealed that combining therapy is associated with fewer acute exacerbations in COPD, but in most of the studies, high-dose combination therapies have been employed. The current study assessed the effect of moderate or high-dose combination therapy of ICS plus LABA on the frequency of acute exacerbations in COPD. Methods : Between January 1, 2001 and August 31, 2004, 46 patients with COPD (moderate, severe, very severe) were enrolled who received either fluticasone/salmeterol (flu/sal) 250μg /50μg twice a day (group A) or flu/sal 500μg /50μg twice a day (group B) for more than a year. We divided them into two groups depending on the dosage of ICS plus LABA. Effect of drugs was compared based on the factors such as symptom aggravation, number of admission, and time to first exacerbation during a year after use. Results : Eleven of twenty-six patients in group A (42.3%) experienced acute exacerbation and eleven of twenty patients in group B (55%) experienced acute exacerbation during 1 year. Mean exacerbation rate of Group A was 0.96 and Group B was 1.05. Mean admission rate was 0.15 and 0.30, respectively. There was no statistically significant difference of aggravation rate, number of administration and time to first exacerbation between the two treatment groups. Conclusion : There was no significant difference between moderate and high dose combined inhaler therapy to reduce acute exacerbation in COPD patients (moderate, severe, very severe). Hence, the effective dose of combination therapy needs further study in patients with COPD. (Tuberc Respir Dis 2005; 59: 164-169)
- keywords
- COPD, Acute exacerbation, Inhaled corticosteroids, Long acting β2-agonist, COPD, Acute exacerbation, Inhaled corticosteroids, Long acting β2-agonist
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