Long-term survival outcomes associated with inhalation therapy in chronic obstructive pulmonary disease: a 5-year multicenter prospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Chronic obstructive pulmonary disease (COPD) represents a significant global health challenge, characterized by high mortality rates. While inhalation therapies, specifically long-acting bronchodilators (LABD) and inhaled corticosteroids (ICS), are known to relieve symptoms and enhance lung function, their long-term effects on survival remain inadequately explored. This 5-year prospective, multicenter observational cohort study included 370 spirometry-confirmed COPD patients recruited from 29 hospitals in Japan. Patients who had undergone lung resection surgery or who lacked follow-up information were excluded. Patients were categorized based on their use of LABD or ICS. Overall survival was evaluated using Kaplan–Meier curves and multivariable-adjusted Cox proportional hazards models. ICS use did not show a significant effect on survival outcomes. In contrast, use of LABD was associated with significantly improved overall survival, especially in patients with severe or very severe COPD ( P < 0.01). The multivariable-adjusted hazard ratio for all-cause mortality associated with LABD use was significantly lower at 0.32 (95% confidence interval 0.13–0.82, P = 0.02). LABD might be effective in improving long-term survival in COPD patients, particularly those in the severe or very severe stage. The use of ICS did not significantly affect survival outcomes. These results support the use of LABD in managing COPD and suggest that further research is needed to better understand the role of ICS in COPD management.
Authors: Genta Akiyama, Hiroaki Ogata, Kazuya Tsubouchi, Tomotsugu Takano, Katsuyuki Ichiki, Ryo Torii, Shohei Takata, Noriaki Nakagaki, Makoto Yoshida, Yasuhiko Kitasato, Kazunori Tobino, Eiji Harada, Hiroshi Wataya, Hiroshi Ishii, Takashige Maeyama, Masayuki Kawasaki, Masaki Fujita, Kazuhiro Yatera, Yoshiaki Zaizen, Fumiaki Kiyomi, Yoichi Nakanishi, Isamu Okamoto
Institutions: Kyushu University, University of Occupational and Environmental Health Japan, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, Fukuoka Higashi Medical Center, Japanese Red Cross Fukuoka Hospital, Fukuoka Hospital, Kurume General Hospital, Aso Iizuka Hospital, Kitakyushu Municipal Medical Center, Harasanshin Hospital, Fukuoka University, Hamanomachi Hospital, Omuta hospital, Kurume University, Kitakyushu City Hospital Organization
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7140163342