Dual bronchodilation with indacaterol–glycopyrronium significantly improved both lung and cardiac function in patients with chronic obstructive pulmonary disease (COPD) and lung hyperinflation. The findings come from the CLAIM study and were published in The Lancet Respiratory Medicine.
A total of 62 participants with COPD, pulmonary hyperinflation, a smoking history of ≥10 pack-years, and airflow limitation were enrolled and randomly assigned to receive either indacaterol–glycopyrronium followed by placebo (n=30) or placebo followed by indacaterol–glycopyrronium (n=32). The primary endpoint of the study was the effect of 14-day indacaterol-glycopyrronium treatment on left ventricular end-diastolic volume (LV-EDV) as measured by MRI.
Results showed that after treatment with indacaterol-glycopyrronium, LV-EDV increased from a mean 55.46mL/m2 (SD 15.89) at baseline to a least-squares (LS) mean of 61.76mL/m2 (95% CI 57.68–65.84); after placebo, LV-EDV changed from 56.42mL/m2 at baseline (13.54) to 56.53mL/m2 (52.43–60.62), LS means difference 5.23 mL/m2 (95% CI 3.22 to 7.25; P<0.0001).
The authors note that this is the first study to investigate the effect of long-acting β agonist (LABA)/muscarinic antagonist (LAMA) combination therapy on cardiac function in COPD patients with lung hyperinflation. “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 conclude.
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