Oxygen Treatment Ineffective for Some COPD Patients

Long-term oxygen treatment did not improve survival in patients with COPD with moderately low blood oxygen levels.

Findings from a recent study suggest that long-term oxygen treatment may not be beneficial for a majority of patients with chronic obstructive pulmonary disease (COPD) who also have moderately low levels of blood oxygen.

COPD is a chronic lung disease that is typically the result of smoking cigarettes, and includes symptoms such as shortness of breath, chronic coughing, wheezing, and low levels of blood oxygen.

Previous research indicated that long-term oxygen treatment was able to benefit patients with extremely low blood oxygen levels, but a benefit was not determined on patients with moderately low levels. In the study, published by the New England Journal of Medicine, investigators found the treatment was not able to reduce hospital admissions or increase survival in this group of patients.

Long-term oxygen treatment is a standard treatment for patients with COPD and low levels of blood oxygen. The treatment involves the use of metal tanks that extract oxygen from the air, and then delivers it to the patient through a tube or mask.

Included in the study were 738 patients who had moderately low blood oxygen levels during rest or exercise. These patients had blood oxygen saturation between 89% and 93% during resting, or below 90% during a 6-minute walk, according to the study.

The Long-term Oxygen Treatment Trial (LOTT) study was started in 2009 and completed in 2015. Not only did the investigators find no survival benefit, they also found no differences in symptom control between patients receiving the treatment and those who were not.

No statistically significant differences were seen in quality of life, depression, anxiety, lung function, or ability to walk, according to the study.

“These results provide insight into a long-standing question about oxygen use in patients with COPD and moderately low levels of blood oxygen. For the most part, this treatment did not improve or prolong life in study participants,” said James P. Kiley, PhD, director of National Heart Lung and Blood Institute’s Division of Lung Diseases. “The findings also underscore the need for new treatments for COPD.”

Other treatments include using bronchodilators, steroids, rehabilitation, surgery, or transplants. Researchers are studying the use of new treatments, as well as gene therapy approaches. Currently, there is no cure for COPD, but avoiding the use of tobacco can potentially prevent or delay the disease.

“We want to make it clear that LOTT was not designed to assess individual responses to oxygen treatment and that individual responses can vary. Each COPD patient should discuss their own personal situation with their health care provider,” said William C. Bailey, MD.