Effects of Tiotropium/Olodaterol on Activity-Related Breathlessness, Exercise Endurance and Physical Activity in Patients with COPD: Narrative Review with Meta-/Pooled Analyses

被引:8
作者
Maltais, Francois [1 ]
de la Hoz, Alberto [2 ]
Casaburi, Richard [3 ]
O'Donnell, Denis [4 ,5 ]
机构
[1] Univ Laval, Ctr Rech, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada
[2] Boehringer Ingelheim Pharma GmbH & Co KG, Ingelheim, Germany
[3] Harbor UCLA Med Ctr, Rehabil Clin Trials Ctr, Lundquist Inst Biomed Innovat, Torrance, CA 90509 USA
[4] Kingston Gen Hosp, Kingston, ON, Canada
[5] Queens Univ, Kingston, ON, Canada
关键词
Breathlessness; Chronic obstructive pulmonary disease; Dyspnoea; Exercise endurance; Hyperinflation; Inspiratory capacity; Meta-analysis; Physical activity; Pooled analysis; Tiotropium/olodaterol; OBSTRUCTIVE PULMONARY-DISEASE; TIOTROPIUM PLUS OLODATEROL; FIXED-DOSE COMBINATION; LUNG HYPERINFLATION; DYSPNEA; REHABILITATION; IMPROVEMENT; OUTCOMES; IMPACT; DIFFERENCE;
D O I
10.1007/s12325-020-01557-x
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
One of the most debilitating symptoms of chronic obstructive pulmonary disease (COPD) is breathlessness, which leads to avoidance of physical activities in daily living and hastens clinical deterioration. Treatment of patients with COPD with inhaled long-acting muscarinic antagonist (LAMA)/long-acting beta(2)-agonist (LABA) combination therapy improves airflow limitation, reduces breathlessness compared with LAMA or LABA monotherapies, and improves health status and quality of life. A large clinical trial programme focusing on the effects of tiotropium/olodaterol combination therapy demonstrated that this LAMA/LABA combination improves lung function and reduces hyperinflation (assessed by serial inspiratory capacity measurements) compared with either tiotropium alone or placebo in patients with COPD. Tiotropium/olodaterol also increases exercise endurance capacity and improves patient perception of the intensity of breathlessness compared with placebo. In this narrative review, we focus on the relationship between improving symptoms during activity, the ability to remain active in daily life and how this may impact quality of life. We consider the benefits of therapy optimisation by means of dual bronchodilation with tiotropium/olodaterol, and present new data from meta-analyses/pooled analyses showing that tiotropium/olodaterol improves inspiratory capacity compared with placebo and tiotropium and improves exercise endurance time compared with placebo after 6 weeks of treatment. We also discuss the importance of taking a holistic approach to improving physical activity, including pulmonary rehabilitation and exercise programmes in parallel with bronchodilator therapy and psychological programmes to support behaviour change.
引用
收藏
页码:835 / 853
页数:19
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