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A new protocol for exercise testing in COPD; improved prediction algorithm for WMAX and validation of the endurance test in a placebo-controlled double bronchodilator study

Tufvesson, Ellen LU ; Radner, Finn LU orcid ; Simonsen, Anton LU ; Papapostolou, Georgia LU orcid ; Jarenbäck, Linnea LU ; Jönsson, Saga ; Nihlen, Ulf LU ; Tunsäter, Alf LU ; Ankerst, Jaro LU orcid and Peterson, Stefan LU , et al. (2021) In Therapeutic Advances in Respiratory Disease 15.
Abstract
Two new protocols have been developed for bicycle exercise testing in chronic obstructive pulmonary disease (COPD) with an individualized cardiopulmonary exercise test (ICPET) and subsequent customized endurance test (CET), which generate less interindividual spread in endurance time compared with the standard endurance test. Main objectives of this study were to improve the prediction algorithm for WMAX for the ICPET and validate the CET by examining treatment effects on exercise performance of indacaterol/glycopyrronium (IND/GLY) compared with placebo. Methods: COPD patients, with forced expiratory volume in 1 s (FEV1) 40–80% predicted, were recruited. Pooled baseline data from two previous studies (n = 38) were used for the development... (More)
Two new protocols have been developed for bicycle exercise testing in chronic obstructive pulmonary disease (COPD) with an individualized cardiopulmonary exercise test (ICPET) and subsequent customized endurance test (CET), which generate less interindividual spread in endurance time compared with the standard endurance test. Main objectives of this study were to improve the prediction algorithm for WMAX for the ICPET and validate the CET by examining treatment effects on exercise performance of indacaterol/glycopyrronium (IND/GLY) compared with placebo. Methods: COPD patients, with forced expiratory volume in 1 s (FEV1) 40–80% predicted, were recruited. Pooled baseline data from two previous studies (n = 38) were used for the development of an improved WMAX prediction algorithm. Additional COPD patients (n = 14) were recruited and performed the ICPET, using the new prediction formula at visit 1. Prior to the CET at visits 2 and 3, they were randomized to a single dose of IND/GLY (110/50 µg) or placebo. Results: The improved multiple regression algorithm for WMAX includes diffusing capacity for carbon monoxide (DLCO), FEV1, sex, age and height and correlated to measured WMAX (R2 = 0.89 and slope = 0.89). Treatment with IND/GLY showed improvement in endurance time versus placebo, mean 113 s [95% confidence interval (CI): 6–220], p = 0.037, with more prominent effect in patients with FEV1 < 70% predicted. Conclusion: The two new protocols for ICPET (including the new improved algorithm) and CET were retested with consistent results. In addition, the CET showed a significant and clinically relevant prolongation of endurance time for IND/GLY versus placebo in a small number of patients. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COPD, endurance time, exercise testing, lung function, prediction, W
in
Therapeutic Advances in Respiratory Disease
volume
15
publisher
SAG
external identifiers
  • scopus:85116387954
  • pmid:34590519
ISSN
1753-4658
DOI
10.1177/17534666211037454
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s), 2021.
id
ada30eff-3bce-4a09-994a-c9b2f493c435
date added to LUP
2021-10-25 15:07:25
date last changed
2024-06-15 19:06:48
@article{ada30eff-3bce-4a09-994a-c9b2f493c435,
  abstract     = {{Two new protocols have been developed for bicycle exercise testing in chronic obstructive pulmonary disease (COPD) with an individualized cardiopulmonary exercise test (ICPET) and subsequent customized endurance test (CET), which generate less interindividual spread in endurance time compared with the standard endurance test. Main objectives of this study were to improve the prediction algorithm for WMAX for the ICPET and validate the CET by examining treatment effects on exercise performance of indacaterol/glycopyrronium (IND/GLY) compared with placebo. Methods: COPD patients, with forced expiratory volume in 1 s (FEV1) 40–80% predicted, were recruited. Pooled baseline data from two previous studies (n = 38) were used for the development of an improved WMAX prediction algorithm. Additional COPD patients (n = 14) were recruited and performed the ICPET, using the new prediction formula at visit 1. Prior to the CET at visits 2 and 3, they were randomized to a single dose of IND/GLY (110/50 µg) or placebo. Results: The improved multiple regression algorithm for WMAX includes diffusing capacity for carbon monoxide (DLCO), FEV1, sex, age and height and correlated to measured WMAX (R2 = 0.89 and slope = 0.89). Treatment with IND/GLY showed improvement in endurance time versus placebo, mean 113 s [95% confidence interval (CI): 6–220], p = 0.037, with more prominent effect in patients with FEV1 &lt; 70% predicted. Conclusion: The two new protocols for ICPET (including the new improved algorithm) and CET were retested with consistent results. In addition, the CET showed a significant and clinically relevant prolongation of endurance time for IND/GLY versus placebo in a small number of patients.}},
  author       = {{Tufvesson, Ellen and Radner, Finn and Simonsen, Anton and Papapostolou, Georgia and Jarenbäck, Linnea and Jönsson, Saga and Nihlen, Ulf and Tunsäter, Alf and Ankerst, Jaro and Peterson, Stefan and Bjermer, Leif and Eriksson, Göran}},
  issn         = {{1753-4658}},
  keywords     = {{COPD; endurance time; exercise testing; lung function; prediction; W}},
  language     = {{eng}},
  publisher    = {{SAG}},
  series       = {{Therapeutic Advances in Respiratory Disease}},
  title        = {{A new protocol for exercise testing in COPD; improved prediction algorithm for W<sub>MAX</sub> and validation of the endurance test in a placebo-controlled double bronchodilator study}},
  url          = {{http://dx.doi.org/10.1177/17534666211037454}},
  doi          = {{10.1177/17534666211037454}},
  volume       = {{15}},
  year         = {{2021}},
}