Factors Associated with Reduction of Sedentary Time Following Tiotropium/Olodaterol Therapy in Treatment-Naïve Chronic Obstructive Pulmonary Disease

Abstract

Koichiro Takahashi,1 Hiroki Tashiro,1 Ryo Tajiri,2 Ayako Takamori,2 Masaru Uchida,3 Go Kato,4 Yuki Kurihara,1 Hironori Sadamatsu,1 Takashi Kinoshita,5 Makoto Yoshida,6 Atsushi Kawaguchi,2,7 Shinya Kimura,1 Naoko Sueoka-Aragane,1 Tomotaka Kawayama5 On behalf of Saga-naïve COPD Physical Activity Evaluation (SCOPE) Study Investigator Group1Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan; 2Clinical Research Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga, Japan; 3Division of Internal Medicine, Japan Community Health Care Organization Saga Central Hospital, Saga, Japan; 4Division of Respiratory Medicine, Saga Prefectural Medical Center Koseikan, Saga, Japan; 5Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan; 6Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan; 7Education and Research Center for Community Medicine, Faculty of Medicine, Saga University, Saga, JapanCorrespondence: Koichiro TakahashiDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, JapanEmail [email protected]: Prolonged sedentary behavior is associated with worse prognosis in patients with chronic obstructive pulmonary disease (COPD). Our previous study found that first-line dual therapy with tiotropium/olodaterol significantly reduces sedentary time compared to tiotropium monotherapy in Japanese patients with treatment-naïve COPD, although the characteristics of responders to dual-therapy versus monotherapy for COPD are still unclear.Methods: Patients with treatment-naïve COPD were randomized to receive either tiotropium or tiotropium/olodaterol treatment for 12 weeks. Physical activity was assessed using a triaxle accelerometer for 2 weeks before and after treatment. This analysis focused on the change in sedentary time, indicated by physical activity of 1.0– 1.5 metabolic equivalents (METs), with stratification for the following factors: age, body mass index (BMI), pulmonary function, COPD assessment test (CAT), the 6-minute walk distance (6MWD), and physical activity level at study entry.Results: Thirty-five patients received tiotropium/olodaterol and 34 patients received tiotropium. In patients with lower inspiratory capacity at study entry, a significant reduction in sedentary time was observed in the tiotropium/olodaterol group compared with the tiotropium group (Tio: − 12.8 ± 13.5 min, Tio/Olo: − 65.1 ± 21.0 min, mean difference, − 52.2 min, 95% CI − 103.6 to 0.88, p = 0.046). In patients with a shorter duration of physical activity of ≥ 2 METs at study entry, a significant reduction of sedentary time was observed in the tiotropium/olodaterol group compared with the tiotropium group (Tio: − 3.3 ± 17.5 min, Tio/Olo: − 72.9 ± 23.1 min, mean difference, − 69.7 min, 95% CI − 128.7 to − 10.6, p = 0.02). There were no differences in terms of age, BMI, CAT score, 6MWD, FEV1, FVC, VC, and physical activity of 1.0– 1.5 METs and ≥ 3.0 METs.Conclusion: This study showed that COPD patients with lower inspiratory capacity or shorter active time of ≥ 2.0 METs at study entry are likely to exhibit significantly greater reduction in sedentary time with tiotropium/olodaterol treatment.Keywords: chronic obstructive pulmonary disease, physical activity, sedentary time, long-acting muscarinic antagonist, long-acting beta 2 agonist

Keywords

• chronic obstructive pulmonary disease
• physical activity
• sedentary time
• long-acting muscarinic antagonist
• long-acting beta 2 agonist