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Observational Study
. 2023 May 26:18:995-1002.
doi: 10.2147/COPD.S407238. eCollection 2023.

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

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 Pelaia  1
Affiliations
Observational Study

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

Corrado Pelaia et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: 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; airway resistance; dual inhaled therapy; exacerbations; lung function.

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Conflict of interest statement

The authors declare that there is no conflict of interest in this work.

Figures

Figure 1
Figure 1
Effects of a 52-week treatment with UMEC/VI on TLC (A), RV (B), IC (C), ITGV (D), and ERV (E). *p < 0.05; ****p < 0.0001.
Figure 2
Figure 2
Effects of a 52-week treatment with UMEC/VI on FEV1 (A), FVC (B), PEF (C), FEF25–75 (D), and DLCOcSB (E). *p < 0.05; **p < 0.01; ****p < 0.0001.
Figure 3
Figure 3
Effects of a 52-week treatment with UMEC/VI on Rtot (A), Reff (B), and sReff (C). ****p < 0.0001.
Figure 4
Figure 4
Effects of a 52-week treatment with UMEC/VI on mMRC dyspnea scale (A), CAT score (B), and COPD exacerbations (C). ****p < 0.0001.
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