Effects of combined tiotropium/olodaterol on inspiratory capacity and exercise endurance in COPD

• Published in: The European respiratory journal Vol. 49; no. 4; p. 1601348
• Main Authors: O'Donnell, Denis E, Casaburi, Richard, Frith, Peter, Kirsten, Anne, De Sousa, Dorothy, Hamilton, Alan, Xue, Wenqiong, Maltais, François
• Format: Journal Article
• Language: English
• Published: England European Respiratory Society Journals Ltd 01-04-2017; European Respiratory Society
• Subjects: Adult; Aged; Benzoxazines - administration & dosage; Bronchodilator Agents - administration & dosage; Chronic obstructive pulmonary disease; Cross-Over Studies; Double-Blind Method; Drug Combinations; Dyspnea; Exercise Tolerance - drug effects; Female; Forced Expiratory Volume - drug effects; Humans; Inspiratory Capacity - drug effects; Lung diseases; Male; Middle Aged; Nebulizers and Vaporizers; Obstructive lung disease; Original; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiration; Statistical analysis; Tiotropium Bromide - administration & dosage
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/13993003.01348-2016

Two replicate, double-blind, 6-week, incomplete-crossover studies (MORACTO 1 and 2) assessed the effects of tiotropium/olodaterol on inspiratory capacity and exercise endurance time in patients with moderate to severe chronic obstructive pulmonary disease.For each patient, four of five treatments were administered once daily for 6 weeks, with a 21-day washout between treatments: tiotropium/olodaterol 2.5/5 µg or 5/5 µg, tiotropium 5 µg, olodaterol 5 µg or placebo, all
the Respimat inhaler. Primary outcomes were inspiratory capacity prior to exercise and exercise endurance time during constant work-rate cycle ergometry to symptom limitation at 75% of peak incremental work rate after 6 weeks (2 h post-dose).295 and 291 patients were treated in MORACTO 1 and 2, respectively. Tiotropium/olodaterol 2.5/5 and 5/5 µg provided significant improvements in inspiratory capacity
placebo and monotherapies (p<0.0001), and significant improvements in exercise endurance time
placebo (p<0.0001). Intensity of breathing discomfort was reduced following both doses of tiotropium/olodaterol
placebo (p<0.0001).Once-daily tiotropium/olodaterol yielded improvements in lung hyperinflation
placebo and statistically significant improvements
monotherapies. Tiotropium/olodaterol also showed improvements in dyspnoea and exercise tolerance
placebo but not consistently
monotherapies.