A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study

Sverre Lehmann,1,2 Thomas Ringbæk,3 Anders Løkke,4 Ludger Grote,5 Jan Hedner,6 Eva Lindberg7 1Department of Thoracic Medicine, Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway; 2Section of Thoracic Medicine, Department of Clinical Sc...

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Main Authors: Lehmann S, Ringbæk T, Løkke A, Grote L, Hedner J, Lindberg E
Format: Article
Language:English
Published: Dove Medical Press 2019-01-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/a-randomized-trial-to-determine-the-impact-of-indacaterolglycopyrroniu-peer-reviewed-article-COPD
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author Lehmann S
Ringbæk T
Løkke A
Grote L
Hedner J
Lindberg E
author_facet Lehmann S
Ringbæk T
Løkke A
Grote L
Hedner J
Lindberg E
author_sort Lehmann S
collection DOAJ
description Sverre Lehmann,1,2 Thomas Ringbæk,3 Anders Løkke,4 Ludger Grote,5 Jan Hedner,6 Eva Lindberg7 1Department of Thoracic Medicine, Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway; 2Section of Thoracic Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway; 3Department of Pulmonary Medicine, Hvidovre Hospital, University of Copenhagen, Denmark; 4Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; 5Sleep Disorders Center, Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; 6Department of Internal Medicine, Center for Sleep and Wake Disorders, University of Gothenburg and Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; 7Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, SwedenPurpose: This study investigated the effect of dual bronchodilation with the long-acting β-receptor agonist/long-acting muscarinic antagonist combination, indacaterol/glycopyrronium (IND/GLY), on nighttime oxygenation, lung function, sleep quality, and symptoms in patients with moderate-to-severe COPD.Patients and methods: This was a 4-week, double-blind, multicenter, placebo-controlled, two-period crossover study. Patients were randomized in a 1:1 ratio to receive IND/GLY 110/50 µg once daily or matching placebo. The primary objective was to evaluate the effect of treatment with IND/GLY on mean nighttime oxygenation, compared with placebo. The secondary objective was to determine the time spent <90% in blood oxygen saturation (SpO2) compared with placebo. Exploratory objectives were to assess the effect of IND/GLY, compared with placebo, on sleep quality measured by the Medical Outcomes Study (MOS) Sleep Scale and the COPD and Asthma Sleep Impact Scale (CASIS) questionnaires and on symptoms assessed by COPD Assessment Test (CAT) questionnaire.Results: In total, 38 patients were randomized (n=22, IND/GLY; n=16, placebo). The change in nighttime oxygenation (SpO2) was similar, and there was a comparable difference in time spent <90% SpO2 between IND/GLY and placebo. Increases from baseline for the difference between IND/GLY and placebo for trough FEV1, FVC, and inspiratory capacity (P<0.05) were seen, with a corresponding reduction in residual volume and functional residual capacity (P<0.05). IND/GLY treatment showed an improvement in scores for CAT (P=0.0208), CASIS, and the MOS Sleep Scale measures, Sleep Problems Index I, Sleep Problems Index II (P=0.0315), Sleep Adequacy, Sleep Disturbance Scale, Somnolence Scale, and Short of Breath Scale (P=0.0031).Conclusion: In this study, IND/GLY 110/50 µg once daily improved symptoms, sleep quality, and lung function, but showed no effect on nighttime oxygenation in patients with moderate-to-severe COPD. Keywords: bronchodilator, sleep, hypoxia, quality of life, lung function
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spelling doaj.art-17fd3f5887da418fb50d9fe0ec8e2ae12022-12-21T21:04:37ZengDove Medical PressInternational Journal of COPD1178-20052019-01-01Volume 1419921043467A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep studyLehmann SRingbæk TLøkke AGrote LHedner JLindberg ESverre Lehmann,1,2 Thomas Ringbæk,3 Anders Løkke,4 Ludger Grote,5 Jan Hedner,6 Eva Lindberg7 1Department of Thoracic Medicine, Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway; 2Section of Thoracic Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway; 3Department of Pulmonary Medicine, Hvidovre Hospital, University of Copenhagen, Denmark; 4Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; 5Sleep Disorders Center, Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; 6Department of Internal Medicine, Center for Sleep and Wake Disorders, University of Gothenburg and Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; 7Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, SwedenPurpose: This study investigated the effect of dual bronchodilation with the long-acting β-receptor agonist/long-acting muscarinic antagonist combination, indacaterol/glycopyrronium (IND/GLY), on nighttime oxygenation, lung function, sleep quality, and symptoms in patients with moderate-to-severe COPD.Patients and methods: This was a 4-week, double-blind, multicenter, placebo-controlled, two-period crossover study. Patients were randomized in a 1:1 ratio to receive IND/GLY 110/50 µg once daily or matching placebo. The primary objective was to evaluate the effect of treatment with IND/GLY on mean nighttime oxygenation, compared with placebo. The secondary objective was to determine the time spent <90% in blood oxygen saturation (SpO2) compared with placebo. Exploratory objectives were to assess the effect of IND/GLY, compared with placebo, on sleep quality measured by the Medical Outcomes Study (MOS) Sleep Scale and the COPD and Asthma Sleep Impact Scale (CASIS) questionnaires and on symptoms assessed by COPD Assessment Test (CAT) questionnaire.Results: In total, 38 patients were randomized (n=22, IND/GLY; n=16, placebo). The change in nighttime oxygenation (SpO2) was similar, and there was a comparable difference in time spent <90% SpO2 between IND/GLY and placebo. Increases from baseline for the difference between IND/GLY and placebo for trough FEV1, FVC, and inspiratory capacity (P<0.05) were seen, with a corresponding reduction in residual volume and functional residual capacity (P<0.05). IND/GLY treatment showed an improvement in scores for CAT (P=0.0208), CASIS, and the MOS Sleep Scale measures, Sleep Problems Index I, Sleep Problems Index II (P=0.0315), Sleep Adequacy, Sleep Disturbance Scale, Somnolence Scale, and Short of Breath Scale (P=0.0031).Conclusion: In this study, IND/GLY 110/50 µg once daily improved symptoms, sleep quality, and lung function, but showed no effect on nighttime oxygenation in patients with moderate-to-severe COPD. Keywords: bronchodilator, sleep, hypoxia, quality of life, lung functionhttps://www.dovepress.com/a-randomized-trial-to-determine-the-impact-of-indacaterolglycopyrroniu-peer-reviewed-article-COPDBronchodilatorsleephypoxiaquality of lifelung function
spellingShingle Lehmann S
Ringbæk T
Løkke A
Grote L
Hedner J
Lindberg E
A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study
International Journal of COPD
Bronchodilator
sleep
hypoxia
quality of life
lung function
title A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study
title_full A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study
title_fullStr A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study
title_full_unstemmed A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study
title_short A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study
title_sort randomized trial to determine the impact of indacaterol glycopyrronium on nighttime oxygenation and symptoms in patients with moderate to severe copd the duosleep study
topic Bronchodilator
sleep
hypoxia
quality of life
lung function
url https://www.dovepress.com/a-randomized-trial-to-determine-the-impact-of-indacaterolglycopyrroniu-peer-reviewed-article-COPD
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