TY - JOUR T1 - QVA149 reduces the risk of moderate-to-severe exacerbations compared with open-label tiotropium in patients with severe COPD: The SPARK study JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P898 AU - Jadwiga A. Wedzicha AU - Marc Decramer AU - Petter Olsson AU - Hungta Chen AU - Robert Fogel AU - Donald Banerji Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P898.abstract N2 - IntroductionQVA149 is an approved once-daily (o.d.) dual bronchodilator combination of the LABA, indacaterol, and the LAMA, glycopyrronium (GLY), for the maintenance treatment of patients (pts) with symptomatic COPD. Here we present the results of a post-hoc analysis conducted to evaluate the rate ratio (RR) of exacerbations in pts with severe COPD in the SPARK study.1MethodsThis 64 week, multicentre, double-blind, parallel-group, active-controlled (open-label TIO and GLY) study randomised pts with severe-to-very severe COPD and a history of ≥1 exacerbation in the previous year to receive o.d. QVA149 110/50µg, GLY 50µg or TIO 18µg.ResultsOf the 2224 pts randomised, 1744 had severe COPD (QVA149=579; GLY=584; TIO=581). QVA149 reduced the risk of moderate-to-severe exacerbations vs. GLY by 11% (RR 0.89; 95% CI 0.77, 1.04) and TIO by 15% (RR 0.85; 95% CI 0.73, 0.98) in pts with severe COPD. In a majority of subgroups QVA149, compared with TIO, reduced the risk of moderate-to-severe exacerbations (Figure). A similar reduction in risk of moderate-to-severe exacerbations was also seen with QVA149 compared with GLY in most of the subgroups.ConclusionsRisk of moderate-to-severe exacerbation was reduced in severe patients with COPD who were treated with QVA149 compared with GLY and TIO.Reference1. Wedzicha et al. Lancet Respir Med 2013;1:199–209. ER -