Efficacy of Levosalbutamol/Ipratropium Combination in Early Bronchodilator Reversibility
Ozgun Iyigun
Department of Internal Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
Tugce Uzar
Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
Irem Karaman
Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
Adem Dirican
Department of Pulmonary Medicine, Samsun Medicalpark Hospital, Samsun, Turkey.
Sevket Ozkaya *
Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
*Author to whom correspondence should be addressed.
Abstract
Objective: The bronchodilator test is a useful method for measuring the changes in lung capacity with spirometry after inhaling a short-acting bronchodilator drug to diagnose patients with obstructive lung disease. Although its liquid form was available, the inhaler form of levosalbutamol is a relatively new short-acting bronchodilator. To measure the efficacy of levosalbutamol in acute bronchodilator reversibility, in this study, we aimed to compare the effects of salbutamol and new levosalbutamol/ipratropium combination on early reversibility and FEV1 changes observed in bronchodilator tests.
Methods: Bronchodilator test results of forty-two patients who were selected according to the inclusion criteria were retrospectively analyzed. The results of spirometry analysis were evaluated for twenty-four patients who received salbutamol (Group I) and eighteen patients who received levosalbutamol/ipratropium combination (Group II). Reversibility levels were evaluated as the absolute and percentage changes in FEV1.
Results: The changes of absolute and percentage values of mean FEV1 were 159±118 mL, 12.2%±11.4% in salbutamol (Group I) group and 233±191mL, 18.8%±15.6% in levosalbutamol / ipratropium (Group II) combination (p=0.025 and 0.048, respectively). Although no significant difference was observed in the reversibility results, Group II showed significantly improved FEV1 values compared to Group I.
Conclusion: To the authors’ knowledge, this is the first study demonstrating that the combination of inhalation therapy with levosalbutamol and ipratropium bromide is more beneficial than salbutamol alone in terms of FEV1 improvement in bronchodilator test. We suggest that this combination can be a good candidate for utilization in diagnostic bronchodilator tests since it proved a specific higher improvement in FEV1 values.
Keywords: Asthma, COPD, spirometry, reversibility, bronchodilator agents, levosalbutamol, ipratropium bromide.