TY - JOUR
T1 - The effects of inhaled airway directed pharmacotherapy on decline in lung function parameters among Indigenous Australian adults with and without underlying airway disease
AU - Heraganahally, Subash S.
AU - Ponneri, Tarun R.
AU - Howarth, Timothy P.
AU - Saad, Helmi Ben
N1 - Publisher Copyright:
© 2021 Heraganahally et al.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Background: The trajectory of lung function decline among Indigenous patients with or without underlying chronic airway disease (COPD and concomitant bronchiectasis) and with use of inhaled pharmacotherapy, including inhaled corticosteroids (ICS), has not been reported in the past. Methods: Adult Indigenous Australian patients identified to have undergone at least two or more lung function tests (LFTs) between 2012 and 2020 were assessed for changes in the lung function parameters (LFPs) between the first and last recorded LFTs. Results: Of the total 1350 patients identified to have undergone LFTs, 965 were assessed to fulfil session quality, 115 (n=58 females) were eligible to be included with two or more LFTs. Among the 115 patients, 49% showed radiological evidence of airway diseases, and 77% were on airway directed inhaled pharmacotherapy. Median time between LFTs was 1.5 years (IQR 0.86,5.85), with no significant differences in LFPs noted between first and last LFT. Overall rate of change (mL/year) showed considerable variation for FVC (median −37.55 mL/year [IQR −159.88,92.67]) and FEV1 (−18.74 mL/year [−102.49,71.44]) with minimal change in FEV1/FVC (0.00 ratio/year [−0.03,0.01]). When stratified by inhaled pharmacotherapy group, however, patients using ICS showed significantly greater rate of FEV1 decline (−48.64 mL/year [−110.18,62.5]) compared to those using pharmacotherapy with no ICS (15.46 mL/year [−73.5,74.62]) and those using no pharmacotherapy (−5.76 mL/ year [−63.19,67.34]) (p=0.022). Additionally, a greater proportion of these patients reached the threshold for excessive FEV1 decline (64%) compared to those using pharmacotherapy without ICS (44%) and those using no pharmacotherapy (52%). Conclusion: Decline in LFPs occurs commonly among adult Indigenous population, especially, excessive so among those using inhaled pharmacotherapy containing ICS.
AB - Background: The trajectory of lung function decline among Indigenous patients with or without underlying chronic airway disease (COPD and concomitant bronchiectasis) and with use of inhaled pharmacotherapy, including inhaled corticosteroids (ICS), has not been reported in the past. Methods: Adult Indigenous Australian patients identified to have undergone at least two or more lung function tests (LFTs) between 2012 and 2020 were assessed for changes in the lung function parameters (LFPs) between the first and last recorded LFTs. Results: Of the total 1350 patients identified to have undergone LFTs, 965 were assessed to fulfil session quality, 115 (n=58 females) were eligible to be included with two or more LFTs. Among the 115 patients, 49% showed radiological evidence of airway diseases, and 77% were on airway directed inhaled pharmacotherapy. Median time between LFTs was 1.5 years (IQR 0.86,5.85), with no significant differences in LFPs noted between first and last LFT. Overall rate of change (mL/year) showed considerable variation for FVC (median −37.55 mL/year [IQR −159.88,92.67]) and FEV1 (−18.74 mL/year [−102.49,71.44]) with minimal change in FEV1/FVC (0.00 ratio/year [−0.03,0.01]). When stratified by inhaled pharmacotherapy group, however, patients using ICS showed significantly greater rate of FEV1 decline (−48.64 mL/year [−110.18,62.5]) compared to those using pharmacotherapy with no ICS (15.46 mL/year [−73.5,74.62]) and those using no pharmacotherapy (−5.76 mL/ year [−63.19,67.34]) (p=0.022). Additionally, a greater proportion of these patients reached the threshold for excessive FEV1 decline (64%) compared to those using pharmacotherapy without ICS (44%) and those using no pharmacotherapy (52%). Conclusion: Decline in LFPs occurs commonly among adult Indigenous population, especially, excessive so among those using inhaled pharmacotherapy containing ICS.
KW - Aboriginal
KW - Bronchiectasis
KW - COPD
KW - ICS
KW - Indigenous
KW - Inhaled corticosteroids
KW - LFT
KW - Lung function test
UR - http://www.scopus.com/inward/record.url?scp=85116400748&partnerID=8YFLogxK
U2 - 10.2147/COPD.S328137
DO - 10.2147/COPD.S328137
M3 - Article
C2 - 34616149
AN - SCOPUS:85116400748
SN - 1176-9106
VL - 16
SP - 2707
EP - 2720
JO - International Journal of COPD
JF - International Journal of COPD
ER -
