Jump to main content
US EPA
United States Environmental Protection Agency
Search
Search
Main menu
Environmental Topics
Laws & Regulations
About EPA
Health & Environmental Research Online (HERO)
Contact Us
Print
Feedback
Export to File
Search:
This record has one attached file:
Add More Files
Attach File(s):
Display Name for File*:
Save
Citation
Tags
HERO ID
8280874
Reference Type
Journal Article
Title
Relationship between exercise endurance and static hyperinflation in a post hoc analysis of two clinical trials in patients with COPD
Author(s)
Singh, S; Maltais, F; Tombs, L; Fahy, WA; Vahdati-Bolouri, M; Locantore, N; Riley, JH
Year
2018
Is Peer Reviewed?
1
Journal
International Journal of Chronic Obstructive Pulmonary Disease
ISSN:
1176-9106
EISSN:
1178-2005
Publisher
Dove Medical Press Ltd.
Volume
13
Page Numbers
203-215
Language
English
DOI
10.2147/COPD.S145285
Abstract
Background: Lung hyperinflation and exercise intolerance are hallmarks of chronic obstructive pulmonary disease (COPD). However, their relationship remains uncertain. A combined analysis of two placebo-controlled, randomized studies examined the effects of the long-acting muscarinic antagonist umeclidinium (Umec) and long-acting β2-agonist vilanterol (Vi) separately and in combination on static hyperinflation, exercise endurance time (EET), and their relationship in patients with COPD. Methods: Patients with moderate-to-severe stable COPD and resting functional residual capacity >120% predicted were randomized to Umec/Vi 62.5/25 µg, Umec 62.5 µg, Vi 25 µg, or placebo for 12 weeks. Inspiratory capacity (IC), residual volume (RV), total lung capacity (TLC), and EET in an endurance shuttle-walk test were measured. In this post hoc analysis, IC/TLC, RV/TLC, and IC were used as hyperinflation markers. Results: After 12 weeks, Umec/Vi and Umec and Vi showed significant improvements in hyperinflation versus placebo when measured by absolute change from baseline in IC/TLC (trough and 3 hours postdose [Pâ¤0.011]). Umec/Vi showed significant improvements versus Umec and Vi in absolute changes in IC/TLC (trough and 3 hours postdose [Pâ¤0.001]). Statistical significance for comparisons with placebo and between treatments for absolute changes in IC and percentage changes in RV/TLC followed similar patterns to those for absolute changes in IC/TLC. Umec/Vi showed significant improvements in EET versus placebo at day 2 and week 12, measured as change from baseline in seconds (Pâ¤0.002) and as a percentage from baseline (Pâ¤0.005). There was a lack of evidence to suggest a correlation between improvements in static hyperinflation and EET at any time point. Conclusion: Although the dual bronchodilator Umec/Vi demonstrated greater improvements in static hyperinflation markers than Umec or Vi and significant improvements in exercise endurance, no direct relationship was observed between static hyperinflation and exercise endurance. © 2018 Singh et al.
Keywords
Bronchodilators; COPD; Exercise; Hyperinflation
Home
Learn about HERO
Using HERO
Search HERO
Projects in HERO
Risk Assessment
Transparency & Integrity