Boehringer Ingelheim announced the first results from the phase IIIb/IV PHYSACTO trial that showed Stiolto Respimat, combined with exercise training, helps people with COPD walk for longer periods of time compared to those receiving placebo. All participants of the trial were also enrolled in a self-management behavior modification program, which provided health education and skills to help better manage COPD. These data were presented at the European Respiratory Society (ERS) International Congress 2016 in London.
In the PHYSACTO trial, exercise capacity was measured by the length of time people with COPD could walk in an Endurance Shuttle Walking Test, which measures how far someone can walk at a standard speed without stopping for a rest.
After 8 weeks, in the tiotropium+olodaterol Respimat combined with exercise training arm, exercise capacity in people with moderate-to-severe COPD significantly increased by 45.8 percent (p<0.001), compared to those receiving placebo with no exercise training (356 vs. 244 seconds respectively). Furthermore, tiotropium+olodaterol Respimat was shown to reduce shortness of breath (also known as dyspnea) associated with physical activity, compared to placebo.
Long-acting beta2-adrenergic agonists, such as olodaterol, one of the active ingredients in Stiolto Respimat, increase the risk of asthma-related death. Stiolto Respimat is not indicated for asthma and should not be initiated in acutely deteriorating COPD patients or for the relief of acute symptoms. Stiolto Respimat is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, olodaterol, or any component of this product. As with other inhaled medicines, Stiolto Respimat may cause paradoxical bronchospasm that may be life-threatening. The most common adverse reactions were nasopharyngitis, cough and back pain.
"It is vital for people with COPD to stay active as this may help slow the progression of disease burden," said study investigator Professor Thierry Troosters, Head, Research Group for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Belgium. "This new study is the first to demonstrate that a holistic approach to COPD management, which includes behavior modification enriched with exercise training and effective long acting bronchodilator therapy, can improve exercise capacity and reduce shortness of breath."
Additional PHYSACTO results showed that even without exercise training, there was a significant improvement in exercise capacity in the tiotropium+olodaterol Respimat arm (29.2 percent increase in shuttle walk duration; p<0.05), compared to placebo (315 vs. 244 seconds respectively).
COPD is a serious but manageable lung disease. Even in the early stages of COPD, people may experience breathlessness during daily activities. To avoid shortness of breath, people with COPD often reduce the amount of physical activity they undertake and do less of their daily activities. This reduction in physical activities has a significant negative impact on their quality of life and can lead to their condition worsening.
The PHYSACTO trial was designed to assess the effect of COPD maintenance therapy alone or in combination with supervised exercise training on exercise capacity and physical activity outcomes, including the amount of physical activity (as measured by an activity monitor) and perceived difficulties (as measured by the Functional Performance Inventory-Short Form score).
The participants of the PHYSACTO trial were randomized into groups, which received either tiotropium+olodaterol Respimat with and without exercise training, tiotropium alone, or placebo. A 12-week self-management behavior modification program was included for all four groups to provide an optimal environment for translating improvements in exercise capacity into increases in daily activity. The self-management behavior modification program included strategies for participants to help them exercise, including a pedometer (a device to count steps), and education to support their COPD management plan.
These new data build on results from the MORACTO and TORRACTO 1&2 studies that showed tiotropium+olodaterol Respimat significantly improved exercise endurance time vs. placebo. The PHYSACTO trial is part of the large-scale TOviTO phase III clinical trial program, investigating the efficacy and safety of tiotropium+olodaterol RESPIMAT in COPD.
Respimat, the platform inhaler for the Boehringer Ingelheim respiratory therapies, was designed to get medicine deep into patients' lungs as a slow-moving mist. The slow moving mist of the Respimat inhaler provides patients with enough time to breathe in the medication. The Respimat inhaler operates independent of inspiratory effort, helping patients effectively breathe the medicine into their lungs while minimizing inhalation effort.
As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as coordination between actuation of the inhaler and inspiration through the delivery system. The duration of inhalation should be at least as long as the spray duration (1.5 seconds).
Boehringer Ingelheim's RESPIMAT family of products includes four FDA-approved medicines for COPD and asthma.
Chronic obstructive pulmonary disease (COPD) is a term that includes chronic bronchitis and/or emphysema. This disease can make breathing harder because less air is able to flow in and out of the lungs. Chronic lower respiratory diseases, which include COPD, are the third leading cause of death in the United States, and approximately 15 million Americans have been told by a healthcare provider that they have COPD.
The most common symptom of COPD is shortness of breath, especially with physical activities. Coughing, with or without mucus production, is also a common symptom of COPD. These symptoms can be misunderstood as signs of aging. COPD is usually associated with progressive airway damage and loss that cause breathing to get more difficult.