<p>Effect of tiotropium/olodaterol on sedentary and active time in patients with COPD: post hoc analysis of the VESUTO^® study</p>

Abstract

Background: Patients with COPD are less physically active. This post hoc analysis of a randomized, double-blind, active-controlled, crossover trial assessed the efficacy of oncedaily tiotropium/olodaterol combination therapy versus tiotropium monotherapy in Japanese patients with COPD. Patients and methods: Patients were provided with a three-axis accelerometer to measure sedentary and active behavior defined as 1.0-1.5 metabolic equivalents (METs), ≥2.0 METs, and ≥3.0 METs, respectively. Of the 182 patients enrolled, 131 satisfied the conditions for the present analysis and were randomized to tiotropium monotherapy (n=62) or tiotropium/ olodaterol combination therapy (n=69). Results: Tiotropium/olodaterol combination therapy significantly reduced the duration of 1.0-1.5 MET activity by 8.64 mins (p=0.040) and significantly increased the duration of ≥2.0 MET and ≥3.0 MET activity by 6.51 mins (p=0.017) and 2.60 mins (p=0.008), respectively, compared with tiotropium alone. Subgroup analyses showed that better lung function, milder dyspnea, and higher levels of physical activity at baseline were associated with reduced sedentary time and increased duration of physical activity. Conclusion: Tiotropium/olodaterol combination therapy significantly reduced sedentary time and improved physical activity compared with tiotropium monotherapy. This trial was registered in ClinicalTrials.gov (NCT02629965).

Data Reproducibility and Effectiveness of Bronchodilators for Improving Physical Activity in COPD Patients

“…In two-weeks of monitoring with a triaxial accelerometer (Active Style Pro HJA-750C ® ; Omron Healthcare, Kyoto, Japan), the data of non-wear days (<10 h/day) and days with environmental factors (rainy days), and cases with <3 valid days were excluded from the analysis. In the tiotropium/olodaterol group, The MVPA increased by 2.6 min and sedentary time decreased by 8.64 min in comparison to the tiotropium group [41].…”

“…In the post hoc analysis of the crossover study with tiotropium/olodaterol and tiotropium [41], the change in the duration of MVPA with tiotropium/olodaterol treatment was significantly larger in patients with a better pulmonary functions, less dyspnea, a longer duration of MVPA, and a shorter sedentary time at baseline in comparison to that with tiotropium. Similar results were reported by Hirano et al [45], who noted that the changes in the total PA level with eight-week treatment with the assisted use of procaterol, a short acting beta-2 agonist, were positively correlated with both baseline FVC % predicted and FEV1 % predicted.…”

“…On the other hand, the values of indicators of PA can easily fluctuate based on several factors, in other words, the indicators of PA show poor reproducibility. This might be the reason why the different studies have reported inconsistent results regarding the effects of bronchodilators on PA in COPD patients [31,[39][40][41][42][43][44][45][46][47][48][49][50][51][52]. 'Physical activity' can be defined as "any bodily movement produced by skeletal muscles that results in energy expenditure" [18], but it is usually defined as physically active behavior that is comparable to moderate to vigorous-intensity PA (MVPA) [19,20].…”

“…Among a total of 392 reports related to the effects of bronchodilators on PA in COPD patients that were registered in the PubMed database from 2005 to 2020, 15 reports that measured PA with an accelerometer were selected ( Figure 3) [31,[39][40][41][42][43][44][45][46][47][48][49][50][51][52]. Among these 15 reports, 8 studies reported that bronchodilators were effective for improving PA, 3 studies reported that some bronchodilators were suggested to be effective by some indicators but not other indicators, and 4 studies reported that bronchodilators were ineffective (Tables 2-4).…”

The relationships between three-axis accelerometer measures of physical activity and motor symptoms in patients with Parkinson’s disease: a single-center pilot study

“…The METs for activity and exercise are calculated as a relative value to rest. Although the importance of maintaining PAL or METs measured with a three-axis accelerometer has been recognized in COPD [17,18], few studies with wearable devices have focused on PAL [19,20] or METs [21] in PD patients. Even in these studies, the potential influence of involuntary movement was not considered [19][20][21].…”