For Those Without COPD but Have Respiratory Problems, Bronchodilators Won’t Help, Study Says

Dual bronchodilators, often prescribed for individuals with respiratory symptoms and a history of smoking, but do not have chronic obstructive pulmonary disease (COPD), are ineffective, according to a study published earlier this month.

The findings were published in the New England Journal of Medicine and simultaneously presented at the European Respiratory Society International Congress.

The results show the importance of diagnosing lung conditions through spirometry as well the necessity for more effective therapies for patients without COPD.

The researchers said they conducted the study because there is a lack of data in this population of individuals with a smoking history and preserved lung function but have symptoms of respiratory problems and are treated with COPD medications, including inhaled bronchodilators and glucocorticoids.

"Because spirometry is infrequently performed in primary care, it is unclear whether physicians believe they are treating COPD or whether they believe COPD medications are effective for these patients," the authors wrote.

In the 12-week, randomized, double-blinded study, which was part of the Redefining Therapy in Early COPD for the Pulmonary Trials Cooperative (RETHINC), researchers enrolled 535 adults with symptoms of COPD, aged 40-80, at 1 of 20 US medical centers. Twice each day, study participants used an inhaler that contained either medication or a placebo.
By the end of the trial, some adults in intervention group and the control groups saw slight respiratory improvements, defined as coughing less, producing less phlegm, or feeling less winded, as evaluated through the St. George’s Respiratory Questionnaire.

However, there were no statistically significant differences between those receiving medication or placebo; 56% (128 of 227) of participants who received the medication saw respiratory symptom improvements, compared with 59% (144 of 244) in the placebo group.

"Further research is urgently needed to better understand and treat the respiratory disease in these persons," the authors concluded.