PT  - JOURNAL ARTICLE
AU  - Jose Mª Marin
AU  - Andreas Clemens
AU  - Ricard Casamor
AU  - Walter Castellani
AU  - Lennart Schaper
AU  - Dinesh Saralaya
AU  - Anthony Gunstone
AU  - Konstantinos Kostikas
AU  - Maryam Aalamian-Mattheis
AU  - Kai Beeh
TI  - Effect of glycopyrronium vs tiotropium on pulmonary function and morning symptoms in patients with moderate-to-severe COPD: The SPRING study
AID  - 10.1183/13993003.congress-2015.PA1014
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA1014
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/PA1014.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/PA1014.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Background: Inhaled long-acting antimuscarinic agents are first line bronchodilator options for treatment of stable moderate-to-severe COPD patients (pts). In the GLOW2 trial glycopyrronium (GLY) demonstrated faster onset of action vs open-label tiotropium (TIO), with greater levels of bronchodilation in the initial 4 h following administration.Aim: To show superiority of GLY (50 μg) compared to TIO (18 μg)in FEV1AUC0-4h after first dose in symptomatic patients with moderate to severe COPD. Secondary efficacy objectives included comparisons of symptoms on Day 1 and 28.Methods: This was a prospective multi-centre, randomized, blinded, two-period cross-over study; each treatment lasted 28 days, with 14-19 days wash-out between treatments.Results: Of 124 pts randomized, 70.2% were male, mean age was 65.7 y. Least square means (95% CI) FEV1AUC0-4h after first treatment dose was 1.74 (1.71, 1.77)L for GLY and 1.71 (1.68, 1.74)L for TIO; difference 0.030 (0.004, 0.056)L, p=0.025, in favour of GLY. A numerical difference in improvement of morning COPD symptoms was observed in favour of GLY [mean (SD) -6.9 (6.6) vs -5.9 (6.6) for GLY and TIO respectively (p=0.144)]. GLY was also numerically better in FEV1AUC0-4h when compared to TIO on Day 28. The Day 28 PRO-morning COPD symptom score was not different between treatments. There were no differences in the safety profile between GLY and TIO.Conclusions: GLY demonstrated superiority of GLY compared to TIO in terms of FEV1AUC0-4h after the first dose of treatment, further supporting better bronchodilation with GLY during the 4 h following administration.