PT - JOURNAL ARTICLE AU - Eric D. Bateman AU - Gary T. Ferguson AU - Neil Barnes AU - Nicola Gallagher AU - Yulia Green AU - Michelle Henley AU - Donald Banerji TI - Dual bronchodilation with QVA149 <em>versus</em> single bronchodilator therapy: the SHINE study AID - 10.1183/09031936.00200212 DP - 2013 Dec 01 TA - European Respiratory Journal PG - 1484--1494 VI - 42 IP - 6 4099 - http://erj.ersjournals.com/content/42/6/1484.short 4100 - http://erj.ersjournals.com/content/42/6/1484.full SO - Eur Respir J2013 Dec 01; 42 AB - We investigated the efficacy and safety of dual bronchodilation with QVA149 versus its monocomponents indacaterol and glycopyrronium, tiotropium and placebo in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD).This was a multicentre, randomised, double-blind, placebo- and active-controlled, 26-week trial. Patients (n = 2144) were randomised (2:2:2:2:1) to receive once-daily QVA149 (indacaterol 110 μg/glycopyrronium 50 μg), indacaterol 150 μg, glycopyrronium 50 μg, open-label tiotropium 18 μg or placebo. The primary end-point was trough forced expiratory volume in 1 s (FEV1) at week 26 for QVA149 versus its monocomponents. Secondary end-points included dyspnoea, health status, rescue medication use and safety.Trough FEV1 at week 26 was significantly improved (p&lt;0.001) with QVA149 compared with indacaterol and glycopyrronium (least squares mean (LSM) differences 0.07 L and 0.09 L, respectively), tiotropium and placebo (LSM differences 0.08 L and 0.20 L, respectively); these beneficial effects were sustained throughout the 26-week study. QVA149 significantly improved dyspnoea and health status versus placebo (p&lt;0.001 and p = 0.002, respectively) and tiotropium (p = 0.007 and p = 0.009, respectively) at week 26. All treatments were well tolerated.Dual bronchodilation with once-daily QVA149 demonstrated superior and clinically meaningful outcomes versus placebo and superiority versus treatment with a single bronchodilator, with a safety and tolerability profile similar to placebo, supporting the concept of fixed-dose long-acting muscarinic antagonist/long-acting β2-agonist combinations for the treatment of COPD.Dual indacaterol/glycopyrronium therapy was safe and more efficacious than monotherapy in moderate-to-severe COPD http://ow.ly/p3H5E