Tuberc Respir Dis.  2018 Jan;81(1):13-18. 10.4046/trd.2017.0098.

The Role of Tiotropium+Olodaterol Dual Bronchodilator Therapy in the Management of Chronic Obstructive Pulmonary Disease

• Halpin DM

• KMID: 2420587
• DOI: http://doi.org/10.4046/trd.2017.0098

Abstract

Bronchodilator therapy is central to the management of chronic obstructive pulmonary disease and are recommended as the preferred treatment by the Global Obstructive Lung Disease Initiative (GOLD). Long acting anti-muscarinics (LAMA) and long acting β₂ agonists (LABA) are both more effective than regular short-acting drugs but many patients remain symptomatic despite monotherapy with these drugs. Combination therapy with LAMA and LABA increases the therapeutic benefit while minimizing dose-dependent side effects of long-acting bronchodilator therapy. The TOviTO programme has investigated the benefits of treatment with a combination of tiotropium and olodaterol administered via a single inhaler. Tiotropium+olodaterol 5/5 µg significantly improved forced expiratory volume in 1 second (FEV₁) area under the curve from 0 to 3 hours, trough FEV₁ health status and breathlessness versus the mono-components and placebo. Tiotropium+olodaterol 5/5 µg also increased endurance time and reduced dynamic hyperinflation during constant work rate cycle ergometry. On the basis of these and other studies the 2017 GOLD report recommends escalating to dual bronchodilator therapy in patients in groups B and C if they remain symptomatic or continue to have exacerbations and as initial therapy for patients in group D.

Keyword

Pulmonary Disease; Chronic Obstructive; Tiotropium; Olodaterol

MeSH Terms

Dyspnea
Ergometry
Forced Expiratory Volume
Humans
Lung Diseases
Lung Diseases, Obstructive
Nebulizers and Vaporizers
Pulmonary Disease, Chronic Obstructive*
Tiotropium Bromide
Tiotropium Bromide