Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598308
Posterbegehung – Sektion Klinische Pneumologie
COPD I – Andreas Rembert Koczulla/Marburg, Henrik Watz/Großhansdorf
Georg Thieme Verlag KG Stuttgart · New York

Tiotropium + olodaterol in patients with moderate to severe COPD with chronic bronchitis and/or emphysema

R Buhl
1  Pulmonary Department, Mainz University Hospital
,
E Derom
2  Ghent University Hospital
,
L Bjermer
3  Department of Respiratory Medicine and Allergology, Lund University
,
L Grönke
4  Boehringer Ingelheim Pharma GmbH & Co. KG
,
F Voss
4  Boehringer Ingelheim Pharma GmbH & Co. KG
,
M Fležar
5  Klinika Golnik
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2017 (online)

 

Introduction:

Chronic bronchitis and emphysema are two COPD phenotypes that can affect pharmacologic treatment decisions.

Aims:

Tiotropium (T) + olodaterol (O) was established for COPD treatment in two large Phase III trials. This post hoc analysis assessed the effect of T+O on lung function, symptoms and health-related quality of life (QoL) in patients (pts) with investigator-defined bronchitis and/or emphysema.

Methods:

TONADO® 1+2 were replicate, randomised, double-blind, parallel-group trials. Pts with GOLD 2 – 4 COPD were randomised to once-daily T+O 2.5/5 or 5/5 µg, T 2.5 or 5 µg, or O 5 µg via Respimat® inhaler.1 End points included forced expiratory volume in 1 second (FEV1) area under the curve from 0 – 3 hours (AUC0 – 3) and trough FEV1 responses, St George's Respiratory Questionnaire (SGRQ) and Mahler Transition Dyspnoea Index (TDI). We show results for T+O 5/5 µg, T 5 µg and O 5 µg at Week 24.

Results:

Baseline characteristics were similar between pts with bronchitis (n = 2210), emphysema (n = 2351) or both (n = 1179). Significant improvements in lung function and improvements in SGRQ and TDI were observed with T+O in all groups (Table).

Comparison at Week 24

FEV1 AUC 0 – 3

response

Trough FEV 1

response

SGRQ

TDI

Bronchitis

Yes

T+O vs. O 5 µg

0.145

(0.119, 0.172)***

0.094

(0.068, 0.121)***

-1.32

(-3.14, 0.51)

0.36

(-0.05, 0.77)

T+O vs. T 5 µg

0.105

(0.080, 0.131)***

0.054

(0.028, 0.080)***

0.04

(-1.70, 1.77)

0.25

(-0.15, 0.64)

No

T+O vs. O 5 µg

0.115

(0.093, 0.136)***

0.077

(0.055, 0.100)***

-2.04

(-3.42, -0.65)*

0.47

(0.12, 0.81)*

T+O vs. T 5 µg

0.116

(0.093, 0.138)***

0.065

(0.042, 0.088)***

-2.32

(-3.74, -0.90)*

0.48

(0.12, 0.83)*

Emphysema

Yes

T+O vs. O 5 µg

0.144

(0.121, 0.166)***

0.099

(0.076, 0.122)***

-1.59

(-3.16, -0.02)*

0.45

(0.07, 0.84)*

T+O vs. T 5 µg

0.114

(0.091, 0.136)***

0.065

(0.041, 0.088)***

-1.70

(-3.28, -0.12)*

0.46

(0.08, 0.84)*

No

T+O vs. O 5 µg

0.115

(0.091, 0.140)***

0.073

(0.048, 0.098)***

-1.82

(-3.32, -0.32)*

0.40

(0.03, 0.76)*

T+O vs. T 5 µg

0.108

(0.084, 0.132)***

0.056

(0.032, 0.081)***

-0.89

(-2.38, 0.60)

0.27

(-0.09, 0.64)

Both

Yes

T+O vs. O 5 µg

0.154

(0.121, 0.188)***

0.107

(0.073, 0.141)***

-1.37

(-3.86, 1.11)

0.31

(-0.24, 0.85)

T+O vs. T 5 µg

0.108

(0.075, 0.140)***

0.056

(0.023, 0.088)**

0.31

(-2.08, 2.69)

0.15

(-0.38, 0.68)

No

T+O vs. O 5 µg

0.120

(0.101, 0.139)***

0.078

(0.058, 0.098)***

-1.80

(-3.03, -0.58)*

0.45

(0.15, 0.75)*

T+O vs. T 5 µg

0.110

(0.091, 0.130)***

0.061

(0.041, 0.081)***

-1.71

(-2.93, -0.48)*

0.42

(0.11, 0.72)*

*p < 0.05; **p < 0.001; ***p < 0.0001

Conclusions:

In moderate to severe COPD, T+O improves lung function, symptoms and QoL in all pts. Improvements in emphysema pts were slightly superior than in chronic bronchitis pts.

Reference:

[1] Buhl R et al. Eur Respir J 2015;45:969 – 79.

Funding:

Boehringer Ingelheim

Content already presented at ERS congress 2016