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Effect of long-acting beta-2 agonists on small airways among patients with chronic lower respiratory symptoms - A clinicospirometric evaluation

Sujoy Mukherjee, Goutam Banerjee, Anil Baran Singha Mahapatra.


Background: Long-acting beta-2 agonists (LABA) are recommended for regular use to control chronic lower respiratory symptoms (LRS). However, LABAs may have the potency to modulate the lung pathology by suppressing the ongoing bronchial inflammation, leaving such patients at greater risk of severe complications.

Aims and Objectives: The aim of this study was to evaluate the effect of inhaled LABA medications on small airways in patients with chronic LRS by spirometric screening at a tertiary hospital.

Materials and Methods: A total of 240 urban patients (aged 25–50 years; both genders) with LRS referred from outdoor patients for spirometric screening were included in this study. After obtaining detailed clinical profile, patients were divided into two groups based on inhaled medications history: Lone LABA users (n = 130) and combined bronchodilator (BDRs) regimen (LABA + inhaled corticosteroids) users group (n = 110). Spirometry was carried out following recommendations of the American Thoracic Society/European Respiratory Society (2005). Patients were categorized based on forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, FEF25–75%, and peak expiratory flow rate values.

Results: A study revealed that those patients were treated with lone LABA inhalers chronically, persistence of small airways obstruction was significantly higher in them compared to combined BDRs regimen user group.

Conclusion: The present study explores better efficacy of combined usage of combined BDRs regimen and potential masking effect of lone LABA in small airway diseases with respect to clinicospirometry study.

Key words: Long-acting Beta-2 Agonists; Small Airways Obstruction; Spirometry

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