Abstract
Background: We carried out a systematic review and meta-analysis with the aim to evaluate the efficacy of long-acting bronchodilators on exercise capacity in COPD patients. Methods: The endpoints were the efficacy of long-acting bronchodilators (altogether, and by single classes) vs. placebo in modifying endurance time (ET), inspiratory capacity (IC) and dyspnea during exercise, taking into consideration the outcomes according to different patients' inclusion criteria and exercise methodology. Results: Twenty-two studies were deemed eligible for analysis. Weighted mean increase in ET resulted of 67 s (95% CI ranges from 55 to 79). For isotime IC and dyspnea during exercise, weighted improvements were 195 ml (162-229), and - 0.41 units (- 0.56 to - 0.27), respectively. The increase in trough IC was 157 ml (138-175). We found a trend in favour of LAMA compared to LABA in terms of ET. In the 11 studies which reported a value of functional residual capacity > 120% as inclusion criterion, weighted mean increase in endurance time was 94 s (65 to 123); however we did not find any significant correlation between ET and mean trough IC (P: 0.593). The improvement of ET in the 5 studies using walking as exercise methodology resulted of 58 s (- 4 to 121). Conclusions: Long-acting bronchodilators improve exercise capacity in COPD. The main effect of long-acting bronchodilators seems to be a decrease of basal IC rather than a modification of dynamic hyperinflation during exercise. The efficacy in terms of endurance time seems higher in studies which enrolled patients with hyperinflation, with a similar efficacy on walking or cycling.
| Original language | English |
|---|---|
| Article number | 18 |
| Journal | Respiratory Research |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 24 2018 |
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Keywords
- Bronchodilator
- COPD
- Exercise
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Long-acting bronchodilators improve exercise capacity in COPD patients : A systematic review and meta-analysis. / Di Marco, Fabiano; Sotgiu, Giovanni; Santus, Pierachille; O'Donnell, Denis E.; Beeh, Kai Michael; Dore, Simone; Roggi, Maria Adelaide; Giuliani, Lisa; Blasi, Francesco; Centanni, Stefano.
In: Respiratory Research, Vol. 19, No. 1, 18, 24.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-acting bronchodilators improve exercise capacity in COPD patients
T2 - A systematic review and meta-analysis
AU - Di Marco, Fabiano
AU - Sotgiu, Giovanni
AU - Santus, Pierachille
AU - O'Donnell, Denis E.
AU - Beeh, Kai Michael
AU - Dore, Simone
AU - Roggi, Maria Adelaide
AU - Giuliani, Lisa
AU - Blasi, Francesco
AU - Centanni, Stefano
PY - 2018/1/24
Y1 - 2018/1/24
N2 - Background: We carried out a systematic review and meta-analysis with the aim to evaluate the efficacy of long-acting bronchodilators on exercise capacity in COPD patients. Methods: The endpoints were the efficacy of long-acting bronchodilators (altogether, and by single classes) vs. placebo in modifying endurance time (ET), inspiratory capacity (IC) and dyspnea during exercise, taking into consideration the outcomes according to different patients' inclusion criteria and exercise methodology. Results: Twenty-two studies were deemed eligible for analysis. Weighted mean increase in ET resulted of 67 s (95% CI ranges from 55 to 79). For isotime IC and dyspnea during exercise, weighted improvements were 195 ml (162-229), and - 0.41 units (- 0.56 to - 0.27), respectively. The increase in trough IC was 157 ml (138-175). We found a trend in favour of LAMA compared to LABA in terms of ET. In the 11 studies which reported a value of functional residual capacity > 120% as inclusion criterion, weighted mean increase in endurance time was 94 s (65 to 123); however we did not find any significant correlation between ET and mean trough IC (P: 0.593). The improvement of ET in the 5 studies using walking as exercise methodology resulted of 58 s (- 4 to 121). Conclusions: Long-acting bronchodilators improve exercise capacity in COPD. The main effect of long-acting bronchodilators seems to be a decrease of basal IC rather than a modification of dynamic hyperinflation during exercise. The efficacy in terms of endurance time seems higher in studies which enrolled patients with hyperinflation, with a similar efficacy on walking or cycling.
AB - Background: We carried out a systematic review and meta-analysis with the aim to evaluate the efficacy of long-acting bronchodilators on exercise capacity in COPD patients. Methods: The endpoints were the efficacy of long-acting bronchodilators (altogether, and by single classes) vs. placebo in modifying endurance time (ET), inspiratory capacity (IC) and dyspnea during exercise, taking into consideration the outcomes according to different patients' inclusion criteria and exercise methodology. Results: Twenty-two studies were deemed eligible for analysis. Weighted mean increase in ET resulted of 67 s (95% CI ranges from 55 to 79). For isotime IC and dyspnea during exercise, weighted improvements were 195 ml (162-229), and - 0.41 units (- 0.56 to - 0.27), respectively. The increase in trough IC was 157 ml (138-175). We found a trend in favour of LAMA compared to LABA in terms of ET. In the 11 studies which reported a value of functional residual capacity > 120% as inclusion criterion, weighted mean increase in endurance time was 94 s (65 to 123); however we did not find any significant correlation between ET and mean trough IC (P: 0.593). The improvement of ET in the 5 studies using walking as exercise methodology resulted of 58 s (- 4 to 121). Conclusions: Long-acting bronchodilators improve exercise capacity in COPD. The main effect of long-acting bronchodilators seems to be a decrease of basal IC rather than a modification of dynamic hyperinflation during exercise. The efficacy in terms of endurance time seems higher in studies which enrolled patients with hyperinflation, with a similar efficacy on walking or cycling.
KW - Bronchodilator
KW - COPD
KW - Exercise
UR - http://www.scopus.com/inward/record.url?scp=85041003486&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041003486&partnerID=8YFLogxK
U2 - 10.1186/s12931-018-0721-3
DO - 10.1186/s12931-018-0721-3
M3 - Article
AN - SCOPUS:85041003486
VL - 19
JO - Respiratory Research
JF - Respiratory Research
SN - 1465-9921
IS - 1
M1 - 18
ER -