Source: Annual Congress 2012 - COPD treatments: efficacy and safety
Disease area: Airway diseases

Abstract

RATIONALE: In previous studies tiotropium improved cycle exercise duration in GOLD II-IV COPD patients. This double-blind crossover study (NCT01072396) compared tiotropium with placebo in GOLD I and II COPD using treadmill exercise testing.
METHODS: Patients were current or ex-smokers aged ≥40 y with post-bronchodilator FEV₁/FVC <70%, FEV₁ ≥50% predicted, and dynamic hyperinflation (≥100 mL inspiratory capacity [IC] decrease during incremental treadmill exercise). Patients received tiotropium 18 μg qd and placebo for 6 weeks each (random order, 4-week washout). Patients performed constant work rate treadmill exercise at 80% of peak incremental test work rate before and after each treatment period. The primary endpoint was the difference in exercise isotime IC change from baseline to Week 6 between tiotropium and placebo. Secondary endpoints included change in exercise duration.
RESULTS: Patients (n=126, 52% male) had mean age 61 y, post-bronchodilator FEV₁/FVC 59% and FEV₁ 77% predicted. Baseline IC was 2.27 L and exercise duration 447 s. The difference in change in isotime IC from baseline to Week 6 between tiotropium and placebo was statistically significant (65 mL, P=0.009). The difference in change from baseline in exercise duration between tiotropium and placebo was not significant in the combined GOLD I+II (29.3 s, P=0.109) and GOLD I (-23.5 s, P=0.415) groups, but was statistically significant for GOLD II (63.0 s, P=0.007).
CONCLUSIONS: Tiotropium was associated with reduced lung hyperinflation at rest and during exercise in GOLD I and II COPD patients. Significantly improved exercise duration was observed in GOLD II patients but not the combined or GOLD I groups.

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R. Casaburi, F. Maltais, J. Porszasz, F. Albers, Q. Deng, A. Iqbal, H. Paden, D. O‘Donnell (Torrance, Ridgefield, New York, United States Of America; Quebec, Kingston, Canada). The effect of tiotropium on lung dynamic hyperinflation and treadmill exercise capacity in mild to moderate COPD. Eur Respir J 2012; 40: Suppl. 56, 2110

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