Effect of Tiotropium on Post Pulmonary TB Patients With Obstructive Abnormalities to Lung Function and Quality of Life

Romaito Nasution, Irvan Medison, Deddy Herman, Masrul Basyar

Abstract


Background: Post pulmonary tuberculosis (TB) patients could experience pulmonary function declines which affected their quality of life. Obstrucitve abnormalities were found the most after complete TB treatment and the therapeutic guidelines focused in bronchodilators. The use of bronchodilators could improve lung function and quality of life in post TB patients with obstructive abnormalities. Tiotropium is a bronchodilator that has been shown to be effective in chronic obstructive pulmonary disease (COPD) patients, while its use in post TB patients has not been widely studied.
Methods: This study design was a clinical trial with pre and post test design in post TB patients in Dr.M.Djamil Padang General Hospital and Lubuk Alung Pulmonary Hospital conducted from November 2016 to June 2017.
Results: Of 30 post TB patients, the mean age was 62.77±10.99 years, most were male (63.33%), non-smokers and former smokers (50% each), had interval from complete anti TB drugs to study ≥6 months (53.3%), and moderate level of obstruction (80%). Pulmonary function prior to tiotropium was generally in moderate obstruction (FEV1 68,85±15,77). The mean quality of life prior to tiotropium was 18.27±10.81. There was no improvement in pulmonary function of post TB patients after administration of tiotropium, P=0.920, however, there was an improvement in the quality of life, P=0.009. No adverse events were found in this study.
Conclusions: Administration of 2 months tiotropium in post TB patients had no effects on the improvements of lung function but improved the quality of life. More studies were needed using more patients and longer duration of administration. (J Respir Indo. 2018; 38: 203-9)

Keywords


Post TB; lung function; quality of life; tiotropium

Full Text:

PDF

References


World Health Organization. Global tuberculosis report 2015. 20th ed. Geneva: WHO Press; 2015.p.13-28

Hicks A, Muthukumarasamy S, Maxwell D, Howlett D. Chronic inactive pulmonary tuberculosis and treatment sequele: chest radiographic features. Int J Tuberc Lung Dis. 2014;18:128-33

Ramos LMM, Sulmonett N, Ferreira CS, Hendriques JF, De Miranda SS. Functional profile of patients with tuberculosis sequelae in a university hospital. J Bras Pneumol. 2006;32:43-7

Chung KP, Chen JY, Lee CH, Wu HD, Wang JY, Lee LN. Trends and predictors of changes in pulmonary function after treatment for pulmonary tuberculosis. Clinics. 2011;66:549-56

Jung JW, Choi JC, Shin JW, Kim JY, Choi BW, Park IW. Pulmonary impairment in tuberculosis survivors: the korean national health and nutrition examination survey 2008-2012. PLoS One. 2015;10:1-12

Pasipanodya JG, Miller TL, Vecino M, Munguia G, Garmon R, Bae S. Pulmonary impairment after tuberculosis. Chest. 2007;131:1817-24

Hnizdo E, Singh T, Churchyard G. Chronic pulmonary function impairment caused by initial and recurrent pulmonary tuberculosis following treatment. Thorax. 2000;55:32-8

Jordan TS, Spencer EM, Davies P. Tuberculosis bronchiectasis and chronic air flow obstruction. Respirology. 2010;15:62-8

Singh B, Chaudhary O. Trends of pulmonary impairment in persons with treated pulmonary tuberculosis. Int J Med Res Prof. 2015;1:8-11

Kim SJ, Lee J, Park YS, Lee CH, Lee SM, Yim JJ. Effect of airflow limitation on acute exacerbations in patients with destroyed lungs by tuberculosis. J Korean Med Sci. 2015;30:737-42

Allwood BW, Myer L, Bateman ED. A systematic review of the association between pulmonary tuberculosis and the development of chronic airflow obstruction in adults. Respiration. 2013;86:76-85

Manji M, Shayo G, Mamuya S, Mpembeni R, Jusabani A and Mugusi F. Lung functions among patients with pulmonary tuberculosis in Dar es Salaam – a cross-sectional study. BMC Pulmon Med. 2016;16:1-9

Nur A, Faisal Y, Muhammad F. Kekerapan hiperreaktivitas bronkus pada bekas tuberkulosis paru di Rumah Sakit Umum Pusat Persahabatan Jakarta. MKI. 1996;46:535-44

Nora A, Irvan M, Oea K, Masrul B. Gangguan fungsi paru dan respon terhadap bronkodilator pada pasien bekas tuberkulosis paru. Thesis Departemen Pulmonologi dan Ilmu Kedokteran Respirasi FK Universitas Andalas. Padang; 2015

Lam KH, Jiang CQ, Jordan RE, Miller MR, Zhang WS, Cheng KK. Prior TB, smoking, and airflow obstruction: a cross-sectional analysis of the Guangzhou Biobank cohort study. Chest. 2010; 137:593-600

Yum HK, Park IN. Effect of inhaled tiotropium on spirometric parameters in patients with tuberculous destroyed lung. Tuberc Respir Dis. 2014;77:167-71

Lee JH, Chang JH. Lung function in patients with chronic airflow obstruction due to tuberculous destroyed lung. Respir Med. 2003;97:1237-42

Baig IM, Saeed W, Khalil KF. Post-tuberculous chronic obstructive pulmonary disease. J Coll Physicians Surg Pak. 2010;20:542-4

Oyong P, Taufik, Yusrizal C, Oea K. Gangguan fungsi paru dan faktor – faktor yang mempengaruhi serta hubungannya dengan kualitas hidup pasien bekas tuberkulosis. Thesis Departemen Pulmonologi dan Ilmu Kedokteran Respirasi FK Universitas Andalas. Padang; 2014

Lee BY, Lee S, Lee JS, Song JW, Lee SD, Jang SH. Validity and reliability of CAT and Dyspnea-12 in bronchiectasis and tuberculous destroyed lung. Tuberc Respir Dis. 2012;72:467-74

Pasipanodya JG, Miller TL, Vecino M, Munguia G, Bae S, Drewyer G. Using the St. George Respiratory Questionnaire to ascertain health quality in persons with treated pulmonary tuberculosis. Chest. 2007;132:1591-7

Chakrabarti B, Calverley PMA, Davies PDO. Tuberculosis and its incidence, special nature, and relationship with chronic obstructive pulmonary disease. Int J COPD. 2007;2:263-72

Leung AN. Pulmonary tuberculosis: the essentials. Radiology. 1999;210:307-22

Lee SW, Kim YS, Kim D, Oh Y, Lee S. The risk of obstructive lung disease by previous pulmonary tuberculosis in a country with intermediate burden of tuberculosis. J Korean Med Sci. 2011;26:268-73

Lawn SD, Zumla AI. Tuberculosis. Lancet. 2011;378:57-72

Radovic M, Ristic L, Stankovic I, Pejcic T, Rancic M, Ciric Z. Chronic airflow obstruction syndrome due to pulmonary tuberculosis treated with directly observed therapy-a serious change in lung function. Med Arh. 2011;65:265-9

Di Naso FC, Pereira JS, Schuh SJ, Unis G. Functional evaluation in patients with pulmonary tuberculosis sequelae. Rev Port Pneumol. 2011;17:216-21

Godoy MDP, Mello FCQ, Lopes AJ, Costa W, Gumairaes FS, Pacheco AGF. The functional assessment of patients with pulmonary multidrug-resistant tuberculosis. Respir Care. 2012;57:1949-54

Ko Y, Lee YM, Lee HY, Lee YS, Song JW, Hong GY. Changes in lung function according to disease extent before and after pulmonary tuberculosis. Int J Tuberc Lung Dis. 2015;19:589-95

Barr RG, Bourbeau J, Camargo CA, Ram FSF. Tiotropium for stable chronic obstructive pulmonary disease: a meta-analysis. Thorax. 2006;61:854-62




DOI: https://doi.org/10.36497/jri.v38i4.22

Refbacks

  • There are currently no refbacks.





Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org


An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License

Statcounter