Effectiveness of pulmonary rehabilitation in individuals with Chronic Obstructive Pulmonary Disease according to inhaled therapy: The Maugeri study

Real-life studies report discordant prescribing of inhaled triple therapy (TT) among individuals with COPD. Guidelines recommend pulmonary rehabilitation (PR) for persistent breathlessness and/or exercise limitation. This real-life study aimed to assess the effects of in-patient PR in individuals un...

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Bibliographic Details
Published in:Respiratory medicine 2022-10, Vol.202, p.106967-106967, Article 106967
Main Authors: Vitacca, Michele, Paneroni, Mara, Spanevello, Antonio, Ceriana, Piero, Balbi, Bruno, Salvi, Beatrice, Ambrosino, Nicolino
Format: Article
Language:English
Subjects:
Airflow limitation
Bronchodilators
CAT
COPD triple therapy
Dyspnoea
Exercise capacity
Exercise training
Inhaled steroids
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Summary:Real-life studies report discordant prescribing of inhaled triple therapy (TT) among individuals with COPD. Guidelines recommend pulmonary rehabilitation (PR) for persistent breathlessness and/or exercise limitation. This real-life study aimed to assess the effects of in-patient PR in individuals under TT as compared to other inhaled therapies (no TT). Multicentric, retrospective analysis of data from individuals admitted to in-hospital PR. Baseline characteristics were recorded and lung function was assessed. Outcome measures were: 6-min walking test (6MWT: primary outcome), Medical Research Council (MRC) scale for dyspnoea, and COPD assessment test (CAT). Data of pre and post program 6MWT of 1139 individuals were available. Pulmonary rehabilitation resulted in significant improvement in 6MWT in both groups, however, the effect size (by 54.3 ± 69.7 vs 42.5 ± 64.2 m, p = 0.004) and proportion of individuals reaching the minimal clinically important difference (MCID) of 6MWT (64.2%, vs 54.3%, p = 0.001) were higher in TT group. Both groups significantly improved also the other outcome measures. The significant independent predictors of reaching the MCID of 6MWT were hospital provenience, TT use, and high eosinophils count. Pulmonary rehabilitation results in significant benefits in individuals with COPD irrespective of the use of TT. However, individuals under TT report larger benefits in exercise tolerance than those under no TT. •Effects of pulmonary rehabilitation in COPD under inhaled triple therapy (TT) as compared to individuals not using TT are unclear.•Significant post program improvements in 6MWT were found in both groups.•Effect size and % of individuals reaching the MCID of 6MWT were higher in TT group.•Independent predictors for MCID of 6MWT were hospital provenience, TT use, and high eosinophils count.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2022.106967