Effects of Tiotropium/Olodaterol on Activity-Related Breathlessness, Exercise Endurance and Physical Activity in Patient
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REVIEW
Effects of Tiotropium/Olodaterol on Activity-Related Breathlessness, Exercise Endurance and Physical Activity in Patients with COPD: Narrative Review with Meta-/Pooled Analyses Franc¸ois Maltais . Alberto de la Hoz . Richard Casaburi . Denis O’Donnell
Received: August 14, 2020 / Accepted: October 29, 2020 Ó The Author(s) 2020
Abstract: One of the most debilitating symptoms of chronic obstructive pulmonary disease (COPD) is breathlessness, which leads to avoidance of physical activities in daily living and hastens clinical deterioration. Treatment of patients with COPD with inhaled long-acting muscarinic antagonist (LAMA)/long-acting b2agonist (LABA) combination therapy improves airflow limitation, reduces breathlessness compared with LAMA or LABA monotherapies, and improves health status and quality of life. A large clinical trial programme focusing on the effects of tiotropium/olodaterol combination therapy demonstrated that this LAMA/LABA combination improves lung function and reduces hyperinflation (assessed by serial F. Maltais (&) Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Que´bec, Universite´ Laval, Quebec City, Canada e-mail: [email protected] A. de la Hoz Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany R. Casaburi Rehabilitation Clinical Trials Center, Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA D. O’Donnell Kingston General Hospital, Kingston, ON, Canada D. O’Donnell Queen’s University, Kingston, ON, Canada
inspiratory capacity measurements) compared with either tiotropium alone or placebo in patients with COPD. Tiotropium/olodaterol also increases exercise endurance capacity and improves patient perception of the intensity of breathlessness compared with placebo. In this narrative review, we focus on the relationship between improving symptoms during activity, the ability to remain active in daily life and how this may impact quality of life. We consider the benefits of therapy optimisation by means of dual bronchodilation with tiotropium/olodaterol, and present new data from meta-analyses/pooled analyses showing that tiotropium/ olodaterol improves inspiratory capacity compared with placebo and tiotropium and improves exercise endurance time compared with placebo after 6 weeks of treatment. We also discuss the importance of taking a holistic approach to improving physical activity, including pulmonary rehabilitation and exercise programmes in parallel with bronchodilator therapy and psychological programmes to support behaviour change.
Adv Ther
Graphic Abstract:
Keywords: Breathlessness; Chronic obstructive pulmonary disease; Dyspnoea; Exercise endurance; Hyperinflation; Inspiratory capacity; Meta-analysis; Physical activity; Pooled analysis; Tiotropium/olodaterol
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