A pilot study assessing the effect of bronchodilator on dynamic hyperinflation in LAM.

Abstract

INTRODUCTION:

Positive responses to bronchodilators (BDs) on spirometry can be found in up to 30% of patients with lymphangioleiomyomatosis (LAM). However, no previous studies have investigated the impact of BDs on exercise outcomes, including dynamic hyperinflation (DH).

METHODS:

A randomised, double-blind, placebo-controlled, crossover trial was conducted on 38 patients with LAM, comparing inhaled placebo versus salbutamol. Pulmonary function tests and a cycle endurance test at 75% of the maximal work capacity, with evaluation of DH by serial measurement of inspiratory capacity (IC), which was the primary endpoint, were performed after each intervention.

RESULTS:

Although salbutamol produced a slight improvement in airway obstruction, compared with placebo, there was no significant variation in resting IC or air trapping. A total of 18% of the patients met the criteria for a positive response to BD. During submaximal exercise, BD did not reduce DH or dyspnoea nor did it improve exercise tolerance in the entire population. In addition, BD produced only slight improvement in FEV1 and air trapping in patients who had DH during incremental cardiopulmonary exercise testing, without the beneficial effects on exercise outcomes.

CONCLUSIONS:

Although salbutamol produced a slight improvement in airway obstruction, it did not lead to a reduction in DH or increase in exercise tolerance in patients with LAM.

CLINICAL TRIAL REGISTRATION:

Brazilian Registry of Clinical Trials (ReBEC); www.ensaiosclinicos.gov.br; registration number: RBR-49sk2j.

• Authors: Bruno Guedes Baldi, André Luis Pereira de Albuquerque, Suzana Pinheiro Pimenta, João Marcos Salge, Ronaldo Adib Kairalla, Carlos Roberto Ribeiro Carvalho
• Journal: Respiratory medicine (Respir Med) Vol. 107 Issue 11 Pg. 1773-80 (Nov 2013) ISSN: 1532-3064 [Electronic] England
• PMID: 24064347 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Adrenergic beta-2 Receptor Agonists
• Bronchodilator Agents
• Albuterol

Topics

• Adrenergic beta-2 Receptor Agonists (therapeutic use)
• Adult
• Albuterol (therapeutic use)
• Bronchodilator Agents (therapeutic use)
• Cross-Over Studies
• Double-Blind Method
• Dyspnea (drug therapy, etiology, physiopathology)
• Exercise Test (methods)
• Exercise Tolerance (drug effects, physiology)
• Forced Expiratory Volume (drug effects)
• Humans
• Lymphangioleiomyomatosis (complications, drug therapy, physiopathology)
• Middle Aged
• Pilot Projects
• Pulmonary Disease, Chronic Obstructive (drug therapy, etiology, physiopathology)
• Respiratory Function Tests (methods)
• Treatment Outcome
• Vital Capacity (drug effects)