Among patients with chronic obstructive pulmonary disease (COPD) who were not receiving inhaled corticosteroids, tiotropium/olodaterol therapy improved outcomes compared with tiotropium monotherapy, according to research being presented at the CHEST Annual Meeting 2019.
Researchers pooled data from the TONADO 1 and 2 and OTEMTO 1 and 2 phase III clinical trials, which included patients with COPD. In the post-hoc analysis, researchers compared tiotropium/olodaterol 5/5 μg versus tiotropium 5 μg for trough forced expiratory volume in 1 section (FEV1) response, FEV1 area under the curve from zero to three hours (AUC0-3), St. George’s Respiratory Questionnaire (SGRQ) total score change from baseline, and transition dyspnea index (TDI) score at 12 weeks. The final cohort included 1,581 patients.
There was a significantly greater increase in FEV1 AUC0-3 among patients receiving tiotropium/olodaterol (0.296 L) compared with tiotropium monotherapy (0.193 L) from baseline to week 12 (95% confidence interval [CI], 0.085-0.122; P<0.0001). Trough FEV1 was also significantly increased in the tiotropium/olodaterol cohort (0.141 L vs. 0.086) from baseline to week 12 (95% CI, 0.036-0.073; P<0.0001). SGRQ total score also improved more in the tiotropium/olodaterol cohort (–6.317 vs. –4.399; 95% CI, –2.994 to –0.843; P=0.0005), as did the TDI score (2.154 vs. 1.579; 95% CI, 0.301-0.848; P<0.0001).
In a subgroup analysis based on Global Initiative for Chronic Obstructive Lung Disease stage (II and III) and symptoms at baseline (baseline dyspnea index and SGRQ), the researchers observed improvements in lung function in the tiotropium/olodaterol cohort compared with tiotropium monotherapy, regardless of COPD severity and symptoms at baseline.
“Optimizing bronchodilator treatment with tiotropium/olodaterol consistently improved lung function and symptoms compared with tiotropium monotherapy,” the researchers concluded. “Dual bronchodilator therapy improves key COPD outcomes across severities and background therapies and may be considered as an earlier treatment option.”
- Calverley P, de la Hoz A, Xue W, et al. Tiotropium/olodaterol therapy improves lung function, symptoms, and impact of disease vs monotherapy in steroid-free patients with COPD. Presented at the CHEST Annual Meeting 2019. October 19-23, 2019; New Orleans, Louisiana.