Retrospective study on the use of LABA/LAMA therapy (long acting bronchodilator agent/long acting muscarinic agent) in patients with severe COPD at first diagnosis

This is a preliminary retrospective work in which we evaluated the effects of LABA/LAMA treatment on newly diagnosed COPD patients. These are patients at first diagnosis, who had never received bronchodilator therapy, all former tobacco smokers. At baseline the median FEV1 (forced expiratory volume in 1 second) was lower than 50% of predicted and the Tiffeneau index indicated obstruction; they also had an important static hyperinflation, evidenced by increase in residual volume. Resistances, measured through plethysmography and oscillometry, were substantially increased, too. All patients were treated with Indacaterol/Glycopyrronium 85/43 microgrammes once a day. After 6-month therapy we had the following results. FEV1 and Tiffeneau index didn’t improve (P=0.17). Conversely, static alveolar hyperinflation decreased significantly, as demonstrated by residual volume (RV) values (P=0.004) and total lung capacity. 6-minute walk test (6mWT) bettered, too, achieving statistical significance (P = 0.008). We saw the greatest statistically significant improvement in the reduction of both global resistance of the thoraco-pulmonary system and of the airways, as an expression of the patients’ better ability to breathe out (P <0.0001); oscillometric indices of elastance improved in a statistically significant way (P=0.004), too. No modification, however, was noted in the alveolus-capillary diffusion values and in the absolute eosinophil count. The correlation between RV, resistances and 6mWT was statistically positive. The improvement of resistances affects the RV because it reduces the alveolar static hyperinflation.