TY - JOUR T1 - The combination therapy with inhaled tiotropium bromide and indacaterol in COPD improves the peripheral airway function in static and dynamic status JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P896 AU - Yasuhiro Setoguchi Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P896.abstract N2 - BACKGROUND: Recently, it has been reported that Indacaterol combined with inhaled Tiotropium bromide in COPD has significant benefits in dyspnea and SGRQ score as well as pulmonary function. This report suggests a reduction in pulmonary hyperinflation resulting from the improvement of peripheral airway obstruction by the combination therapy (Mahler DA, et al. Thorax 67:781-8, 2012)OBJECTIVES: We physiologically examined the effects to peripheral airway obstruction in COPD by the combination therapy with inhaled tiotropium bromide and Indacaterol.METHODS: Clinically stable COPD patients were enrolled. Following a 2-week run-in period, patients were randomly allocated to three groups by the envelope method; then they received inhaled tiotropium 18ug q.d. monotherapy (Tio), inhaled indacaterol 150ug q.d. monotherapy (Inda) or combination therapy with inhaled tiotropium q.d. and indacaterol 150ug q.d. (COM) for 4 weeks each by the crossover method. Spirometry, and Impulse Oscillometry (IOS) were performed.RESULTS: 35 patients (11 in Tio , 12 in Inda, 12 in COM) were analyzed. Compared with monotherapy, COM therapy resulted in significantly improvement of FEV1 and FVC. Peripheral airway function in regular ventilation and after 50% increased hyperventilation as evaluated IOS [X5 (reactance of 5Hz) and AX (integration of reactance from 5 to 20 Hz)] exhibited significant improvement in the combination therapy compared to monotherapy.CONCLUSIONS: These results suggest that the combination therapy may be more effective in improving peripheral airway function in not only static but also dynamic ventilation in COPD than monotherapy. ER -