Survey to determine the efficacy and safety of guideline-based pharmacological therapy for chronic obstructive pulmonary disease patients not previously receiving maintenance treatment.
OBJECTIVE
To investigate the potential beneficial effects of guideline-based pharmacological therapy on pulmonary function and quality of life (QOL) in Japanese chronic obstructive pulmonary disease (COPD) patients without prior treatment.


METHODS
Multicenter survey, open-label study of 49 Japanese COPD patients aged ≥ 40 years; outpatients with >10 pack years of smoking history; ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < 70%; predicted FEV1 < 80%; treated with bronchodilators and/or inhaled corticosteroids as maintenance therapy until week 48.


METHODS
The primary endpoint was change in pulmonary function (trough FEV1, trough FVC); secondary endpoints were QOL and physical activity at 48 weeks after initiation of therapy.


RESULTS
Airway reversibility was confirmed in untreated patients. Significant changes over time were not observed for FEV1 and FVC, indicating lung function at initiation of treatment was maintained during the observation period. COPD assessment test scores showed statistical and clinical improvements. Cough, sputum, breathlessness, and shortness of breath were significantly improved.


CONCLUSIONS
Lung function and QOL of untreated Japanese COPD patients improved and improvements were maintained by performing a therapeutic intervention that conformed to published guidelines.
a 1 Tokyo Medical University, Department of Respiratory Medicine , 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan +81 333 426 111 ; +81 333 425 070 ; ystgc@tokyo-med.ac.jp.
Yasuhiro
Y
Setoguchi
b 2 National Center for Global Health and Medicine, Department of Respiratory Medicine , Tokyo, Japan.
Shinyu
S
Izumi
c 3 Seirei Hamamatsu General Hospital, Department of Respiratory Medicine , Shizuoka, Japan.
Hidenori
H
Nakamura
d 4 Respiratory Center, Toranomon Hospital, Department of Respiratory Medicine , Tokyo, Japan.
Shigeo
S
Hanada
e 5 Tokyo Metropolitan Police Hospital, Department of Internal Medicine , Tokyo, Japan.
Kazuyoshi
K
Marumo
f 6 Fukujuji Hospital, Department of Diagnostic Radiology , Tokyo, Japan.
Atsuko
A
Kurosaki
g 7 Tokyo Medical University, Department of Radiology , Tokyo, Japan.
Shouichi
S
Akata
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D003371:Cough / Q000188:drug therapy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014797:Vital Capacity
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents
chronic obstructive pulmonary disease; chronic obstructive pulmonary disease assessment test; forced expiratory volume in 1 second; forced vital capacity; long-acting bronchodilators; quality of life