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

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          Abstract

          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 via 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 versus placebo and monotherapies (p<0.0001), and significant improvements in exercise endurance time versus placebo (p<0.0001). Intensity of breathing discomfort was reduced following both doses of tiotropium/olodaterol versus placebo (p<0.0001).

          Once-daily tiotropium/olodaterol yielded improvements in lung hyperinflation versus placebo and statistically significant improvements versus monotherapies. Tiotropium/olodaterol also showed improvements in dyspnoea and exercise tolerance versus placebo but not consistently versus monotherapies.

          Abstract

          T/O reduces lung hyperinflation in COPD versus T, O or placebo and increases exercise endurance versus placebo http://ow.ly/ml3G307XW6a

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          Most cited references37

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          ATS/ACCP Statement on cardiopulmonary exercise testing.

          , (2003)
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            Lung volumes and forced ventilatory flows.

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              An official European Respiratory Society statement on physical activity in COPD.

              This European Respiratory Society (ERS) statement provides a comprehensive overview on physical activity in patients with chronic obstructive pulmonary disease (COPD). A multidisciplinary Task Force of experts representing the ERS Scientific Group 01.02 "Rehabilitation and Chronic Care" determined the overall scope of this statement through consensus. Focused literature reviews were conducted in key topic areas and the final content of this Statement was agreed upon by all members. The current knowledge regarding physical activity in COPD is presented, including the definition of physical activity, the consequences of physical inactivity on lung function decline and COPD incidence, physical activity assessment, prevalence of physical inactivity in COPD, clinical correlates of physical activity, effects of physical inactivity on hospitalisations and mortality, and treatment strategies to improve physical activity in patients with COPD. This Task Force identified multiple major areas of research that need to be addressed further in the coming years. These include, but are not limited to, the disease-modifying potential of increased physical activity, and to further understand how improvements in exercise capacity, dyspnoea and self-efficacy following interventions may translate into increased physical activity. The Task Force recommends that this ERS statement should be reviewed periodically (e.g. every 5-8 years).
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                Author and article information

                Journal
                Eur Respir J
                Eur. Respir. J
                ERJ
                erj
                The European Respiratory Journal
                European Respiratory Society
                0903-1936
                1399-3003
                April 2017
                20 April 2017
                : 49
                : 4
                : 1601348
                Affiliations
                [1 ]Division of Respiratory and Critical Care Medicine, Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, ON, Canada
                [2 ]Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA
                [3 ]Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, Australia
                [4 ]Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany
                [5 ]Boehringer Ingelheim, Burlington, ON, Canada
                [6 ]Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, USA
                [7 ]Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
                Author notes
                Denis O'Donnell, Division of Respiratory and Critical Care Medicine, Respiratory Investigation Unit, Queen's University and Kingston General Hospital, 102 Stuart Street, Kingston, K7L 3N6 Ontario, Canada. E-mail: odonnell@ 123456queensu.ca
                Article
                ERJ-01348-2016
                10.1183/13993003.01348-2016
                5898947
                28424359
                3d5cfef0-0749-4866-a55d-1037451f503f
                Copyright ©ERS 2017

                This ERJ Open article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                : 07 July 2016
                : 14 December 2016
                Funding
                Funded by: Boehringer Ingelheim Pharma GmbH & Co. KG
                Categories
                Original Articles
                COPD
                1

                Respiratory medicine
                Respiratory medicine

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