Initiation of moderate-to-vigorous physical activity in COPD patients using dual ultra-long-acting bronchodilators reduced the risk of severe exacerbation (HR 0.81) compared to no regular MVPA.
Cohort (n=6,042)
Does initiation of moderate-to-vigorous physical activity reduce future usage of inhaled corticosteroids and severe exacerbation in COPD patients using a LABA/LAMA combination?
Initiation of moderate-to-vigorous physical activity in COPD patients on dual ultra-long-acting bronchodilators is associated with reduced future use of inhaled corticosteroids and a lower risk of severe exacerbations.
Effect estimate: HR 0.81 (95% CI 0.68, 0.96)
Absolute Event Rate: 3.9% vs 4.9%
p-value: p=<0.01
Inhaler therapy and physical activity (PA) are important methods of chronic obstructive pulmonary disease (COPD) management. This study aimed to investigate the additional benefit of moderate-to-vigorous PA (MVPA) in patients with COPD using a long-acting beta-agonists (LABA)/long-acting muscarinic antagonist (LAMA) combination. We emulated a target trial to estimate the benefit of MVPA in patients with COPD using a dual ultra-long-acting bronchodilators. We enrolled patients aged ≥ 40 who were diagnosed with COPD between 2014 and 2018, initiated a LABA/LAMA combination, and had not undergone regular MVPA. The main exposure was the initiation of MVPA, defined as vigorous aerobic exercise > 20 min per day on ≥ 3 days/week or moderate aerobic exercise > 30 min per day on ≥ 5 days/week. The main outcomes were the future usage of inhaled corticosteroids (ICS) and severe exacerbation. We identified 1,526 patients who initiated MVPA and 4,516 who did not. The median follow-up period was 3.0 years. The hazard ratio (HR) for future ICS usage in the MVPA initiation group was 0.83 (95% confidence intervals (CI): 0.72, 0.97) compared to the control group. The HR for severe exacerbation in the MVPA initiation group was 0.81 (95% CI: 0.68, 0.96) compared to the control group. Subgroup analyses by age, sex, body mass index, residence area, smoking and drinking status showed consistent benefits in these outcomes. Initiation of MVPA may offer an additional benefit for even COPD patients who use a dual ultra-long-acting bronchodilators.
Kim et al. (Sat,) conducted a cohort in Chronic obstructive pulmonary disease (COPD) (n=6,042). Initiation of moderate-to-vigorous physical activity (MVPA) vs. No regular MVPA was evaluated on Severe exacerbation (incidence per 100 person-years) (HR 0.81, 95% CI 0.68, 0.96, p=<0.01). Initiation of moderate-to-vigorous physical activity in COPD patients using dual ultra-long-acting bronchodilators reduced the risk of severe exacerbation (HR 0.81) compared to no regular MVPA.