ArticleThe clinical respiratory journal2026
Temporal and Partial Reversal of Airflow Limitation in Patients With COPD Treated With Single-Inhaler Long-Acting Dual Bronchodilators.
Article in The clinical respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionChronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation. While single-inhaler long-acting dual bronchodilators (LADBs) effectively relieve symptoms and improve lung function, their long-term impact on spirometry outcomes and the potential for meaningful changes in key diagnostic indices in a real-world setting remain underexplored.
methodsThis was a single-country (China), single-center, retrospective, noninterventional, real-world study that included 182 patients treated with LADBs (indacaterol/glycopyrronium [IND/GLY] or umeclidinium/vilanterol [UMEC/VI]). The primary outcomes were changes in trough FEV1 and FEV1/FVC from baseline. Secondary outcomes were changes in other spirometry parameters. An exploratory post hoc analysis explored the reversal of FEV1/FVC, defined as a posttreatment trough FEV1/FVC ratio that exceeded 70%.
resultsSingle-inhaler LADB therapy significantly improved lung function, including FEV1, FVC, FEV1/FVC, RV, and parameters of small airway function. The least-square mean change in trough FEV1 and FEV1/FVC post-treatment was 0.154 L [95% CI: 0.09, 0.218] and 1.929% [95% CI: 0.694, 3.164], respectively, at 24 weeks. Posttreatment FEV1 exhibited a characteristic pattern: an initial increase, followed by a peak, a subsequent slight decline, and eventual stabilization. Patients with lower GOLD grades experienced greater improvement in key spirometry parameters. Notably, 21 patients (11.5%) achieved a reversal of the FEV1/FVC ratio to over 70%. Exploratory logistic regression showed that a better baseline lung function, especially FEV1/FVC ratio, was associated with an increased likelihood of achieving this threshold (OR = 1.52 [95% CI: 1.29, 1.89]).
conclusionThis study demonstrated significant and sustained improvements in lung function in this real-world cohort of COPD patients managed with LABA/LAMA monotherapy. A subset of patients achieved a posttreatment FEV1/FVC ratio above 70%, indicating a potentially meaningful change in airflow limitation after LADB therapy.
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