Comparing Lung Function Improvement in COPD

Richard ZuWallack, MD, a specialist in pulmonary rehabilitation from St. Francis Hospital and Medical Center in Hartford, CT, presented results from 2 studies highlighting lung function improvement in patients with chronic obstructive pulmonary disease (COPD).

The study’s primary focus was to evaluate the efficacy of the bronchodilator combining 2 classes of long-acting bronchodilators, tiotropium (HandiHaler) and olodaterol (Respimat) within clinically stable patients afflicted with (COPD).

The once-daily long-acting muscarinic antagonist tiotropium provides well-established benefits in lung function symptoms in patients with COPD as well as improves health status and reduces exacerbations. Olodaterol is an FDA-approved once-daily LABA, which, under the brand name Striverdi Respimat, has been available by prescription in the US as of last month.

Two studies simultaneously run, parallel studies, ANHELTO-1 and ANHELTO-2, observed the combination of tiotropium and olodaterol versus an active control of tiotropium in moderate to severe COPD patients.

Among the 1,132 participants enrolled in ANHELTO-1 and 1,135 in ANHELTO-2, the average age was 64.6 (49.8%) and 64.1 (53.6%) years. The mean baseline following bronchodilator FEV1 was found to be 54.0% and 53.3%. Additionally, T+O showed remarkable improvements within lung function compared with T+P following 12 weeks.

They had dual primary endpoints; first, FEV1, saw area under the curve up to 3 hours in 1 second. The second end point comprised of trough FEV1 response at 12 weeks plus 1 day.

Data from ANHELTO-1 suggests tiotropium increased the FEV1 area under the curve by 196 mL compared to its own baseline, whereas the combination increased by 313 mL. Results from ANHELTO-2 revealed increased levels of 191 and 297mL, respectively.

The study results concluded that in COPD patients, a combination of olodaterol (Respimat) and tiotropium (HandiHaler) provided a greater bronchodilation compared with tiotropium treatment alone.

The data indicate, “Two good bronchodilators in different classes are better than one good bronchodilator from one class, as far as improving FEV1.” Both trials not only had high peak values, but fairly substantial improvements in FEV1. Also, it was found that rescue medication use decreased significantly and health related quality of life improved.