Treatment Combo Improves Heart Function in COPD Patients
Dual bronchodilation with indacaterol-glycopyrronium is associated with significantly improved cardiac function in patients with chronic obstructive pulmonary disease (COPD) and lung hyperinflation, according to a new study.
In the CLAIM study, the researchers assessed 62 participants aged 40 years or older with COPD, pulmonary hyperinflation, a smoking history of at least 10 pack-years, and airflow limitation.
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Participants were randomly assigned to treatment with either a once-daily combined inhaled dual bronchodilator containing the long-acting β agonist (LABA) indacaterol (110 μg as maleate salt) plus the long-acting muscarinic antagonist (LAMA) glycopyrronium (50 μg as bromide salt) for 14 days, followed by a 14-day washout and a subsequent 14 days with matched placebo (n = 30), or to the same treatments in reverse order (n = 32).
A total of 57 patients completed both periods of treatment. Findings indicated that left-ventricular end-diastolic volume increased from a mean 55.46 mL/m2 at baseline to a least-squares mean of 61.76 mL/m2 following treatment with indacaterol-glycopyrronium, compared with a change from 56.42 mL/m2 at baseline to 56.53 mL/m2 following treatment with placebo.
Cough and throat irritation were the most commonly reported adverse events with indacaterol-glycopyrronium treatment, compared with headache and upper respiratory tract infection with placebo. No patient deaths occurred during the study.
“This is the first study to analyze the effect of LABA-LAMA combination therapy on cardiac function in patients with COPD and lung hyperinflation,” the researchers wrote. “Dual bronchodilation with indacaterol-glycopyrronium significantly improved cardiac function as measured by left-ventricular end-diastolic volume.”
“The results are important because of the known association of cardiovascular impairment with COPD, and support the early use of dual bronchodilation in patients with COPD who show signs of pulmonary hyperinflation,” they concluded.
—Christina Vogt
Reference:
Hohlfeld JM, Vogel-Claussen J, Biller H, et al. Effect of lung deflation with indacaterol plus glycopyrronium on ventricular filling in patients with hyperinflation and COPD (CLAIM): a double-blind, randomised, crossover, placebo-controlled, single-center trial [Published online February 21, 2018]. Lancet Respir Med. https://doi.org/10.1016/S2213-2600(18)30054-7.