This study aims to investigate the prognosis and clinical outcomes of patients with chronic obstructive pulmonary disease (COPD) who continue to experience refractory dyspnea despite treatment with long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA). The research will prospectively follow a cohort of patients to identify clinical factors, lung function parameters, imaging features, and cardiovascular indicators associated with poor treatment response. By comparing these patients with those who show symptom improvement, the study seeks to determine predictors of exacerbations, lung function decline, and mortality. Findings are expected to guide the development of targeted strategies to improve the management of refractory dyspnea in COPD.
Eligibility
Sex
ALL
Min age
18 Years
Max age
100 Years
Healthy volunteers
No
Inclusion Criteria:
* Adults (≥ 18 years) diagnosed with chronic obstructive pulmonary disease (COPD) according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2025 criteria:
* Presence of COPD risk factors (e.g., smoking history, occupational exposure, genetic predisposition).
* Typical symptoms such as dyspnea, cough, or sputum production.
* Post-bronchodilator FEV1/FVC \< 0.70.
* Regular outpatient follow-up at the respiratory clinic.
* Received LABA/LAMA combination therapy for at least 3 months prior to enrollment.
* Ability and willingness to provide written informed consent.
Exclusion Criteria:
* Poor adherence to LABA/LAMA therapy (medication possession rate \< 50%) or refusal of treatment.
* Inability or unwillingness to comply with scheduled visits, examinations, or follow-up procedures.
* Presence of severe comorbid conditions expected to significantly affect prognosis, including:
* End-stage diseases with life expectancy \< 1 year.
* Terminal malignancies receiving hospice or palliative care.
* Any condition that, in the opinion of the investigator, would interfere with study participation or data reliability.
Primary outcome measure(s)
Annual rate of acute exacerbations in COPD — Up to 5 years (annualized rate) Annualized rate of moderate-to-severe exacerbations per patient-year, defined as episodes requiring systemic corticosteroids, antibiotics, or hospitalization.
Moderate exacerbations will be defined as events requiring treatment with systemic corticosteroids and/or antibiotics without hospitalization. Severe exacerbations will be defined as events leading to hospitalization or emergency department visit.
Unit: Number of exacerbations per patient-year
All-cause mortality — 1-, 3-, and 5-year follow-up. Proportion of participants who die from any cause Unit: Percentage of participants (%) or Number of deaths
Trial sites (1)
Facility
City
Region
Status
Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center
Seoul
Seoul
Recruiting
More Seoul National University trials in South Korea
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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