Efficacy and Safety of Inhaled Pharmacotherapy in Patients With Pneumoconiosis and Airway Obstruction: A Retrospective Cohort Study From China.

OBJECTIVE

Pneumoconiosis often coexists with airway obstruction, yet evidence on inhaled pharmacotherapy in this population is limited.

METHODS

We retrospectively studied patients with pneumoconiosis and postbronchodilator forced expiratory volume in one second (FEV 1 )/forced vital capacity <70% (2018-2022). Eligible patients (≥40 years) were grouped by regular (≥12 months) or irregular/no inhaled therapy. Outcomes included FEV 1 , symptoms, exacerbations, hospitalizations, and adverse events. Symptom burden was assessed using the chronic obstructive pulmonary disease Assessment Test and the modified Medical Research Council dyspnea scale. Propensity score matching and logistic regression identified predictors of response.

RESULTS

After matching, 228 patients were analyzed. Regular therapy yielded greater FEV 1 improvement (88 vs. 15 mL, P < 0.001), better chronic obstructive pulmonary disease Assessment Test and modified Medical Research Council responses, and fewer exacerbations and hospitalizations ( P < 0.05), with similar adverse events. Higher baseline FEV 1 % predicted response.

CONCLUSION

Regular inhaled pharmacotherapy improved lung function, symptoms, and exacerbation outcomes in pneumoconiosis with airway obstruction without added safety concerns.