Long-acting bronchodilators improve health related quality of life in patients with COPD

Respir Med. 2013 Oct;107(10):1465-80. doi: 10.1016/j.rmed.2013.08.007. Epub 2013 Aug 31.

Abstract

Background: Long-acting bronchodilators are first-line treatment for chronic obstructive pulmonary disease (COPD), and their efficacy on lung function and clinical parameters is recognized.

Objective: To explore the available evidence about the effects of long acting bronchodilators on Health Related Quality of Life (HRQoL) and Health Status (HS) in clinical research.

Methods: Randomized controlled trials published till December 2012 evaluating HRQoL/HS in COPD by means of validated questionnaires were analysed.

Results: Fifty-one trials on Long acting β2 agonist (LABA) and Long acting Anticholinergic (LAMA) met the inclusion criteria. A total of 37,225 moderate-severe COPD patients testing 6 drugs, 12 different devices and 22 different dosages, with a study duration ranging from 4 weeks to 4 years were studied. A statistical significant HRQoL/HS improvement was reached in 93% of the studies. Nevertheless, the Minimal Important Difference (MID) was reached in 70.6% of the studies considering the difference between baseline and end of the study, and in 50% when comparing active treatment and placebo.

Conclusions: The data coming from the review support the efficacy of long acting bronchodilators in improving HRQoL/HS of COPD patients. Further research evaluating HRQoL/HS as primary outcome and according to guidelines on Patient Reported Outcomes is needed.

Keywords: COPD; Health status; Long-acting bronchodilators; Quality of life.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Bronchodilator Agents / therapeutic use*
  • Cholinergic Antagonists / therapeutic use
  • Humans
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / rehabilitation
  • Quality of Life*
  • Randomized Controlled Trials as Topic

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Bronchodilator Agents
  • Cholinergic Antagonists