Effects of indacaterol/glycopyrronium (QVA149) on lung hyperinflation and physical activity in patients with moderate to severe COPD: a randomised, placebo-controlled, crossover study (The MOVE Study)

Watz, Henrik; Mailänder, Claudia; Baier, Monika; Kirsten, Anne

doi:10.1186/s12890-016-0256-7

Cited by 42 publications

(45 citation statements)

References 34 publications

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“…In that study, exercise capacity was relatively well preserved (463 m 6MWD), perhaps providing more window for improvement as there was a larger functional reserve 34. It is clear that coaching programmes with the specific aim of increasing PA lead to larger improvements in amount of PA compared with rehabilitation,35 and pharmacology 11 12. In the present study, patients in the IG were four times more likely to increase their PA by >1000 steps.…”

Section: Discussionmentioning

confidence: 44%

Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial

Demeyer

Louvaris

Frei

et al. 2017

Thorax

198

340

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RationaleReduced physical activity (PA) in patients with COPD is associated with a poor prognosis. Increasing PA is a key therapeutic target, but thus far few strategies have been found effective in this patient group.ObjectivesTo investigate the effectiveness of a 12-week semiautomated telecoaching intervention on PA in patients with COPD in a multicentre European randomised controlled trial.Methods343 patients from six centres, encompassing a wide spectrum of disease severity, were randomly allocated to either a usual care group (UCG) or a telecoaching intervention group (IG) between June and December 2014. This 12-week intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualised daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. PA was measured using accelerometry during 1 week preceding randomisation and during week 12. Secondary outcomes included exercise capacity and health status. Analyses were based on modified intention to treat.Main resultsBoth groups were comparable at baseline in terms of factors influencing PA. At 12 weeks, the intervention yielded a between-group difference of mean, 95% CI (lower limit – upper limit; ll-ul) +1469, 95% CI (971 to 1965) steps/day and +10.4, 95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all p≤0.001). The change in 6-min walk distance was significantly different (13.4, 95% CI (3.40 to 23.5) m, p<0.01), favouring the IG. In IG patients, an improvement could be observed in the functional state domain of the clinical COPD questionnaire (p=0.03) compared with UCG. Other health status outcomes did not differ.ConclusionsThe amount and intensity of PA can be significantly increased in patients with COPD using a 12-week semiautomated telecoaching intervention including a step counter and an application installed on a smartphone.Trial registration number:NCT02158065.

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Section: Discussionmentioning

confidence: 44%

Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial

Demeyer

Louvaris

Frei

et al. 2017

Thorax

198

340

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“…In addition, metabolic requirements will be lower promoting a better nutritional status. At present, there are wide studies that have been designed to assess the likely synergistic effect of an optimized bronchodilator therapy associated with training programs (209,214). Lung volume reduction by surgery or endoscopy may also have beneficial effects on respiratory muscle function by reducing hyperinflation and improving exercise capacity and daily physical activity of COPD patients (215)(216)(217).…”

Section: Optimization Of the General Treatment Of Copdmentioning

confidence: 99%

Clinical management of chronic obstructive pulmonary disease patients with muscle dysfunction

et al. 2016

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Muscle dysfunction is frequently observed in chronic obstructive pulmonary disease (COPD) patients, contributing to their exercise limitation and a worsening prognosis. The main factor leading to limb muscle dysfunction is deconditioning, whereas respiratory muscle dysfunction is mostly the result of pulmonary hyperinflation. However, both limb and respiratory muscles are also influenced by other negative factors, including smoking, systemic inflammation, nutritional abnormalities, exacerbations and some drugs. Limb muscle weakness is generally diagnosed through voluntary isometric maneuvers such as handgrip or quadriceps muscle contraction (dynamometry); while respiratory muscle loss of strength is usually recognized through a decrease in maximal static pressures measured at the mouth. Both types of measurements have validated reference values. Respiratory muscle strength can also be evaluated determining esophageal, gastric and transdiaphragmatic maximal pressures although there is a lack of widely accepted reference equations. Non-volitional maneuvers, obtained through electrical or magnetic stimulation, can be employed in patients unable to cooperate. Muscle endurance can also be assessed, generally using repeated submaximal maneuvers until exhaustion, but no validated reference values are available yet. The treatment of muscle dysfunction is multidimensional and includes improvement in lifestyle habits (smoking abstinence, healthy diet and a good level of physical activity, preferably outside), nutritional measures (diet supplements and occasionally, anabolic drugs), and different modalities of general and muscle training.

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“…The decrease in the duration and number of exacerbations for the ACLI/FOR combination (versus placebo) observed in the pooled analysis of the AUGMENT COPD and ACLIFORM studies18 was not replicated in individual trials 16,19. Although daily activities were not included in this analysis, only the IND/GLY combination showed some efficacy with respect to this clinical outcome (with the BLAZE trial showing a 8.8% increase in the percentage of days in which the patient was able to perform usual daily activities versus placebo);14 the same combination produced an increase in activity-related energy expenditure (with a 36.7 kcal increase per day versus placebo in the MOVE study) 15…”

Section: Resultsmentioning

confidence: 99%

“…We also aimed to include an assessment of daily activities; unfortunately, only the BLAZE14 and MOVE15 trials focusing on the IND/GLY combination reported such data.…”

Section: Methodsmentioning

confidence: 99%

Double bronchodilation in chronic obstructive pulmonary disease: a crude analysis from a systematic review

Lόpez-Campos

Calero-Acuña

Martín

et al. 2017

COPD

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ObjectiveThe combination of a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA) in a single inhaler is a viable treatment option for patients with chronic obstructive pulmonary disease (COPD). Here, we systematically review the current knowledge on double bronchodilation for the treatment of COPD, with a specific focus on its efficacy versus placebo and/or monotherapy bronchodilation.MethodsA systematic review of clinical trials investigating LABA/LAMA combination therapies was conducted. Articles were retrieved from PubMed, Embase, and Scopus on June 26, 2016. We specifically selected clinical trials with a randomized controlled or crossover design published in any scientific journal showing the following characteristics: 1) comparison of different LABA/LAMA combinations in a single inhaler for patients with COPD, 2) dose approved in Europe, and 3) focus on efficacy (versus placebo and/or bronchodilator monotherapy) in terms of lung function, respiratory symptoms, or exacerbations.ResultsWe analyzed 26 clinical trials conducted on 24,338 patients. All LABA/LAMA combinations were consistently able to improve lung function compared with both placebo and bronchodilator monotherapy. Improvements in symptoms were also consistent versus placebo, showing some lack of correlation for some clinical end points and combinations versus monotherapy bronchodilation. Albeit being an exploratory end point, exacerbations showed an improvement with LABA/LAMA combinations over placebo in some trials; however, scarce information was available in comparison with bronchodilator monotherapy in most studies.ConclusionOur data show consistent improvements for LABA/LAMA combinations, albeit with some variability (depending on the clinical end point, the specific combination, and the comparison group). Clinicians should be aware that these are average differences. All treatments should be tailored at the individual level to optimize clinical outcomes.

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Effects of indacaterol/glycopyrronium (QVA149) on lung hyperinflation and physical activity in patients with moderate to severe COPD: a randomised, placebo-controlled, crossover study (The MOVE Study)

Cited by 42 publications

References 34 publications

Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial

Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial

Clinical management of chronic obstructive pulmonary disease patients with muscle dysfunction

Double bronchodilation in chronic obstructive pulmonary disease: a crude analysis from a systematic review

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