Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients

Abstract

BackgroundImprovements in ventilatory mechanics with tiotropium increases exercise tolerance during pulmonary rehabilitation. We wondered whether tiotropium also increased physical activities outside of pulmonary rehabilitation.MethodsCOPD patients participating in 8 weeks of pulmonary rehabilitation were studied in a randomized, double-blind, placebo-controlled trial of tiotropium 18 μg daily (tiotropium = 47, placebo = 44). Study drug was administered for 5 weeks prior to, 8 weeks during, and 12 weeks following pulmonary rehabilitation. Patients completed a questionnaire documenting participation in pre-defined activities outside of pulmonary rehabilitation during the 2 weeks prior to each visit. Patients who submitted an activity questionnaire at week 4 and on at least one subsequent visit were included in the analysis. For each patient, the number of sessions was multiplied with the duration of each activity and then summed to give overall activity duration.ResultsPatients (n = 46) had mean age of 67 years, mean baseline FEV1 of 0.84 L (33% predicted). Mean (SE) increase in duration of activities (minutes during 2 weeks prior to each visit) from week 4 (prior to PR) to week 13 (end of PR) was 145 (84) minutes with tiotropium and 66 (96) minutes with placebo. The increase from week 4 to week 25 (end of follow-up) was 262 (96) and 60 (93) minutes for the respective groups. Increases in activity duration from week 4 to weeks 17, 21, and 25 were statistically significant with tiotropium. No statistical differences over time were observed within the placebo-treated group and differences between groups were not significant.ConclusionsTiotropium appears to amplify the effectiveness of pulmonary rehabilitation as seen by increases in patient self-reported participation in physical activities.

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

“…Available treatment guidelines describe the use of long-acting inhalation drugs (twice daily: long-acting muscarinic antagonist (LAMA) -aclidinium, long-acting beta2-adrenoreceptor agonist (LABA) -formoterol, salmeterol and once daily: ultra-long-acting muscarinic antagonist (U-LAMA) -tiotropium, glycopyrronium, umeclidinium and ultralong-acting beta2-adrenoreceptor agonist (U-LABA) -indacaterol, olodaterol, vilanterol) in symptomatic patients with post-BD FEV 1 60-80% of the predicted value, and these are highly recommended in symptomatic patients with post-BD FEV 1 <60% of the predicted value 1 . The choice of specific agent depends on the physician, or patient's preference 1,2,4,58,59, [64][65][66][67][68][69][70][71][72][73] .…”

Effect of tiotropium on quality of life in COPD: a systematic review

“…[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] Of the 24 publications that met the inclusion criteria for this systematic review (see Table 1), 16 compared tiotropium with placebo, [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] seven compared tiotropium with an active comparator, [66][67][68][69][70][71][72] and one compared tiotropium with both placebo and an active comparator. 73 The QoL outcomes reported in the 24 included publications were mostly SGRQ and/or TDI (Tables 2 and 3).…”

Evaluation of physical activity in patients with chronic obstructive pulmonary disease: recommendations of European Respiratory Society

“…Известно, что при терапии бронхолитическими пре паратами уменьшается одышка и повышается пе реносимость физических нагрузок, однако эта взаи мосвязь изучена только в нескольких клинических исследованиях [149][150][151]. Получены положительные результаты, а именно -повышение ФА на фоне те рапии бронхолитическими препаратами.…”

“…Получены положительные результаты, а именно -повышение ФА на фоне те рапии бронхолитическими препаратами. В нерандо мизированном открытом исследовании (n = 23) ис пользовался длительно действующий β агонист [150], тогда как в другое исследование был включен рет роспективный анализ подгрупп [151]. В 2 рандоми зированных плацебо контролируемых многоцент ровых исследованиях не установлено изменений ФА на фоне терапии длительно действующим бронходи лататором [149,152].…”