The following article is part of conference coverage from the 2019 American Association of Nurse Practitioners Annual Meeting (AANP 2019) in Indianapolis, Indiana. Clinical Advisor’s staff will be reporting breaking news associated with research conducted by leading nurse practitioners. Check back for the latest news from AANP 2019.


Dual bronchodilation with fixed-dose tiotropium/olodaterol was found to be effective in reducing the exacerbation rate in patients with chronic obstructive pulmonary disease (COPD), according to research presented at the American Association of Nurse Practitioners (AANP) Annual Meeting, held June 18 to 23, 2019, in Indianapolis, Indiana.

In the 1-year, double-blind DYNAGITO trial ( Identifier: NCT02296138), patients with very severe COPD and at least 1 moderate to severe exacerbation in the previous 12 months were randomly assigned to receive tiotropium/olodaterol 5/5 µg or tiotropium 5 µg once daily. Patients were categorized as having COPD grades 2 to 4 (moderate to very severe) based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading system of forced expiratory volume during 1 second (FEV1).

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A total of 2784 patients were categorized as GOLD 2, 4039 patients were categorized as GOLD 3, and 992 patients were categorized as GOLD 4. A long-acting muscarinic antagonist (LAMA) only or a LAMA/long-acting β2 agonist (LABA) was taken by more patients with GOLD grade 2 (12.6% and 13.4%) compared with those with GOLD grade 3 or 4 (7.5% and 12.0%; 5.6% and 8.4%). Triple therapy with LAMA/LABA/inhaled corticosteroid was taken by fewer patients with GOLD grade 2 COPD (32.6%) compared with patients with GOLD grade 3 group (42.8%) or GOLD grade 4 (47.7%). Tiotropium/olodaterol reduced the exacerbation rate vs tiotropium alone in patients with GOLD grades 2 and 3 COPD but not in those patients with GOLD grade 4.

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“The fixed-dose LAMA/LABA combination of tiotropium/olodaterol reduced exacerbations versus tiotropium in patients with GOLD grade 2 (moderate) and grade 3 (severe) COPD,” the authors concluded.

Disclosure:  Some of the authors are employed by Boehringer Ingelheim International GmbH.

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Wedzicha J, Calverley PMA, Anzueto AR, et al. The impact of GOLD stage on the effectiveness of tiotripoum/olodaterol in preventing COPD exacerbations in the DYNAGITO trial. Presented at: The American Association of Nurse Practitioners (AANP) Annual Meeting; June 18-23, 2019; Indianapolis, Indiana. Poster 28.