RT Journal Article SR Electronic T1 Late-breaking abstract: Once-daily NVA237 improves exercise endurance from first dose in patients with COPD: The GLOW3 trial JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 4497 VO 38 IS Suppl 55 A1 Kai-Michael Beeh A1 Anton Drollman A1 Lilli Di Scala A1 Rachel Smith YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/4497.abstract AB Introduction: Exercise limitation, dynamic hyperinflation and exertional dyspnea are key features of COPD. We investigated the effects of NVA237, a once-daily (OD) inhaled long-acting muscarinic antagonist, on exercise endurance in pts with COPD.Methods: 108 pts with moderate-to-severe COPD were randomized to a cross-over design of NVA237 50 μg or placebo OD for 3 weeks, with a 14-day washout. The primary outcome was endurance time during submaximal exercise tolerance test on Day 21 of treatment. Endurance time after first dose, dynamic hyperinflation (inspiratory capacity [IC] at isotime during exercise), and morning trough FEV1 were also measured.Results: On Day 21, endurance time significantly increased by 21% with NVA237 compared with placebo; this effect was significant from Day 1, with an increase of 10% (Table). Dynamic IC at exercise isotime and trough FEV1 showed significant and clinically relevant improvements from Day 1 that were sustained throughout the study (Table). The safety profile of NVA237 was similar to that of placebo.View this table:Conclusion: NVA237 OD produced immediate and significant improvement in exercise endurance from Day 1, accompanied by sustained and significant improvements in IC at isotime and meaningful improvements in trough FEV1. Improvement in endurance time increased over the study period, suggesting that mechanisms beyond improved lung function play a role in enhanced exercise tolerance.