Initial treatment with tiotropium/olodaterol improves physical inactivity in patients with treatment-naïve COPD

Abstract

Background: Bronchodilators improve lung function, QOL and exercise tolerance in patients with COPD, however effects of bronchodilators in physical activity (PA) are still unclear. We investigated the effects of an introduction of bronchodilators on pulmonary function, dyspnea, QOL and PA in patients with treatment-naïve COPD.

Methods: This is a prospective, multicenter, randomized interventional study included 80 treatment-naïve COPD subjects who were randomized to receive either tiotropium (Tio) or tiotropium/olodaterol (Tio/Olo) treatment for 12 weeks. The subjects were examined by pulmonary function tests, BDI/TDI, COPD assessment tests and PA measured using a triaxle accelerometer before and after treatment.

Results: The differences in FEV1.0 after administration of the bronchodilator for 12 weeks were 242.8±28.8 ml for Tio/Olo vs. 104.1±31.9 mL for Tio (p<0.01). The TDI index score was 2.4±0.3 for Tio/Olo vs. 1.5±0.3 for Tio (p=0.02). Duration of PA≥2.0 Metabolic equivalents (METs) increased in both groups (+10.8±7.6 min vs. +8.3±7.6 min in the Tio/Olo vs. Tio group, p=0.82). Duration of PA 1.0-1.5 METs, which represents the sedentary position, tended to reduce more in the Tio/Olo group (-38.7±14.7 min) than the Tio group (-4.2±10.6 min) (p=0.06). The Tio/Olo treatment significantly reduced PA 1.0-1.5 METs (regression coefficient -43.6 [95% CI -84.1 -3.1], p<0.01) after applying multiple regression model with adjusting following factors; age, FEV1.0, CAT, 6MWD and TDI.

Conclusion: These data suggest that Tio/Olo improves not only pulmonary function, but also reduces the time in the sedentary position in patients with treatment-naïve COPD.