Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Factors Associated with Indacaterol Response in Tuberculosis-Destroyed Lung with Airflow Limitation

  • Kim, Tae Hoon (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Rhee, Chin Kook (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Oh, Yeon-Mok (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.06.12
  • Accepted : 2018.09.11
  • Published : 2019.01.31
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Abstract

Background: Pulmonary tuberculosis can result in anatomical sequelae, and cause airflow limitation. However, there are no treatment guidelines for patients with a tuberculosis-destroyed lung. Recently, indacaterol effectiveness in chronic obstructive pulmonary disease (COPD) patients with Tuberculosis history (INFINITY) study revealed indacaterol provided bronchodilation and symptom improvement in COPD patients with a tuberculosis-destroyed lung. Methods: We conducted a post-hoc subgroup analysis of the randomized controlled trial, the INFINITY study, to determine factors associated with indacaterol response in a tuberculosis-destroyed lung with airflow limitation. Data from 68 patients treated with inhaled indacaterol, were extracted and analyzed. Factors associated with the response of forced expiratory volume in one second ($FEV_1$) to indacaterol treatment, were determined using linear regression analysis. Results: Of 62 patients included, 68% were male, and 52% had history of cigarette smoking. Patients revealed mean $FEV_1$ of 50.5% of predicted value with mean improvement of 81.3 mL in $FEV_1$ after indacaterol treatment for 8 weeks. Linear regression analysis revealed factors associated with response of $FEV_1$ to indacaterol included a short duration of smoking history, and high short-acting bronchodilator response. When patients with history of smoking were excluded, factors associated with response of $FEV_1$ to indacaterol included high short-acting bronchodilator response, and poor health-related quality of life score as measured by St. George's Respiratory Questionnaire for COPD. Conclusion: In a tuberculosis-destroyed lung with airflow limitation, short-acting bronchodilator response and smoking history can play a critical role in predicting outcomes of indacaterol treatment.

Keywords

References

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