Long acting B-2 agonists (LABA) or anticholinergics (LAMA): Which one is more efficient in Group A COPD patients?

Abstract

Introduction: Long-acting anticholinergic (LAMA) or beta-2 agonists (LABA) for symptom control in symptomatic group A COPD patients in GOLD guideline, however, there is no mention of priority or superiority between the two treatment options in this patient group. We aimed to compare the effectiveness of long-acting bronchodilator treatments in group A COPD patients.

Method: Group A COPD patients with the treatment of LABA or LAMA were included in the study. Spirometric parameters, COPD Assessment Test (CAT), mMRC Dyspnea scale and St. George Respiratory Questionnaire (SGRQ) results at the initial visit, at sixth month and one year were evaluated.

Results: There were 76 group A COPD patients who were included in the study and joined the visits, 51 of whom were using LAMA (67.1%) and 25 LABA (32.9%). Among both patient groups, the rate of improvement in CAT score at the end of the first year was found to be statistically significantly higher in those using LAMA (p = 0.022); There was no significant difference between LABA and LAMA users at 6 months and 1 year in terms of symptom status, development of exacerbation, mMRC score, PFT parameters and improvement in QOL. In both patient groups, there was a significant improvement in SGRQ total score and activity score in the 1st year in patients who quit smoking compared to active smokers (p = 0.015 and 0.014, respectively).

Conclusion: Significant improvement observed in the CAT score in the group receiving LAMA may cause LAMA treatment to gain treatment priority compared to LABA in group A COPD patients. Active smoking negatively affects the quality of life in all COPD patients, regardless of the treatment used.