Clinical and Functional Effects of Inhaled Dual Therapy Umeclidinium/Vilanterol in Patients with Chronic Obstructive Pulmonary Disease: A Real-Life Study

Abstract

Corrado Pelaia,1 Anna Ferrante Bannera,1 Fioramante Lello Rotundo,1 Francesco Giuseppe Tropea,1 Giuseppe Armentaro,2 Angelantonio Maglio,3 Angela Sciacqua,2 Alessandro Vatrella,3 Girolamo Pelaia1 1Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy; 2Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy; 3Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, ItalyCorrespondence: Corrado Pelaia, Campus Universitario “S. Venuta”, Viale Europa – Località Germaneto, Catanzaro, 88100, Italy, Tel [phone], Fax [phone], Email [email protected]: The pharmacological association umeclidinium/vilanterol (UMEC/VI) allows to implement a very effective dual bronchodilation in chronic obstructive pulmonary disease (COPD), thus optimizing bronchodilating therapy.Methods: The main purpose of our real-world observational study was to evaluate in COPD patients the effects of UMEC/VI on lung function and respiratory symptoms. Functional and clinical parameters were assessed at baseline, and after 52 weeks of treatment with this combined double inhaled therapy.Results: We enrolled 110 subjects suffering from COPD. A 12-month UMEC/VI treatment induced significant improvements in total lung capacity (TLC) (p < 0.05), and residual volume (RV) (p < 0.0001). Pulmonary deflation was paralleled by significant increases of forced expiratory volume in one second (FEV1) (p < 0.0001), forced vital capacity (FVC) (p < 0.01), forced expiratory flow between 25% and 75% of FVC (FEF25– 75) (p < 0.0001) and diffusion capacity of the lung (DLCOcSB) (p < 0.05). In addition, in the same period, we also observed significant reductions of airway resistance including total resistance (Rtot) (p < 0.0001) and specific effective resistance (sReff) (p < 0.0001). Other improvements were detected with regard to modified British Medical Research Council (mMRC) questionnaire score (p < 0.0001), COPD Assessment Test (CAT) score (p < 0.0001), and COPD exacerbation rate (p < 0.0001). In particular, the reported changes of mMRC/CAT scores and COPD exacerbation numbers were significantly correlated with UMEC/VI–induced modifications of TLC, RV, FVC and FEV1.Conclusion: In conclusion, our study corroborates in a real-life context the effectiveness of UMEC/VI in COPD treatment. Indeed, our broad investigational strategy has allowed to better characterize the functional mechanisms underpinning the therapeutic properties of UMEC/VI association.Keywords: COPD, dual inhaled therapy, lung function, airway resistance, exacerbations

Keywords

• copd
• dual inhaled therapy
• lung function
• airway resistance
• exacerbations.