Bronchodilators have long been used in people with respiratory problems that require dilation of the bronchi and bronchioles to reduce respiratory airway resistance and increase the air flowing to the lungs. These bronchodilators can be short-acting, providing quick “rescue” relief or long-acting, helping to prevent symptoms and control the obstructive lung diseases like asthma and chronic obstructive pulmonary disease (COPD).

Though bronchodilators are often prescribed for restrictive lung diseases, there is no clear data on how effective they may be in these conditions. This occurs because there has been an assumption that people who do not meet the criteria for COPD but display relevant symptoms – such as those with a history of smoking tobacco – should benefit from bronchodilators.

A new study, published in the New England Journal of Medicine, investigated whether inhaled dual bronchodilator therapy could help tobacco-exposed people whose lung function did not appear dysfunctional based on spirometry. Physicians along with researchers studied 535 people between the ages of 40 and 80 who had a history of at least 10 pack-years and respiratory symptoms. Twice a day, half these patients used a bronchodilator inhaler while the other half used a placebo inhaler. The randomized, double-blinded study was run for 12 weeks.

The results of the study showed that between 50 and 60% of the study participants saw respiratory improvements over the course of the study. However, there was not a significant difference in improvement between groups, suggesting that the bronchodilator therapy was not effective in reducing respiratory symptoms in this group of patients. According to the authors, these results highlight the value of spirometry as a tool for assessing lung conditions as well as the importance of avoiding assumptions about who will benefit from certain therapies.

Reference

Han MK, Ye W, Wang D, et al. Bronchodilators in Tobacco-Exposed Persons with Symptoms and Preserved Lung Function. https://doi.org/101056/NEJMoa2204752. Published online September 4, 2022. doi:10.1056/NEJMOA2204752