Impact of pharmacotherapy with tiotropium/olodaterol on the pulmonary function in COPD patients depending on the Arg16Gly polymorphism of ADRB2 gene

Abstract

Annotation. Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disease. Endogenic or genetic factors play a significant role in the COPD development. The aim of our study was to investigate a response to the tiotropium/olodaterol treatment in patients with different ADRB2 gene polymorphism. 100 patients with the diagnosis of COPD were included into the study. Pulmonary function testing was performed during all study visits. All patients received treatment according to GOLD 2019, which included a combination of long-acting beta-2 agonists (LABA) and long-acting muscarinic antagonists (LAMA). According to the results of genetic testing all patients were divided into 3 groups: Arg16Arg – 23 patients (23%), Arg16Gly – 39 patients (39%), Gly16Gly – 38 patients (38%). Statistical processing of research materials was carried out using the SPSS statistical program package for Windows version 26.0. Descriptive statistics were determined for each interval variable and presented as mean ± standard deviation (SD). Kolmogorov-Smirnov test, Mann-Whitney test and T-test, Wilkson test, t-test, Kruskal-Wallis test were used as part of the one-way ANOVA analysis, as well as with the analysis of covariance (ANCOVA) followed by pairwise comparison of groups using Bonferroni corrections. Groups did not differ by sex, age, part of smokers, COPD duration. There was significant difference in RLM at the time of inclusion (p=0.01). There was a significant difference in the Pain value at the time of study completion (р=0.024). When comparing values of SGRQ questionnaire, there was a significant difference in the scales of Impact (р=0.006) and Total score (р=0.021). Thus, group Gly16Gly had better dynamics of SF-36 and SGRQ values during the study. Despite the absence of significant difference we can state, that Gly16Gly genotype has better response to treatment when compared to Arg16Arg, which is probably conditioned by the development of sensitization of ADRB2 receptor in Arg16Arg group.