New Data Analyses Provide Insights That May Help Predict COPD Exacerbation Risk

Monday, October 17, 2016 Respiratory Disease News J E 4
- Exacerbations can be life-threatening, and a key goal of COPD treatment is reducing risk of exacerbations

RIDGEFIELD, Conn., Oct. 17, 2016 /PRNewswire/ -- Boehringer Ingelheim today announced new data analyses from the Phase III TONADO® 1&2 trials that build upon existing evidence about the factors that increase the risk of a COPD exacerbation. These data were presented today at the American College of CHEST Physicians Annual Meeting 2016 (CHEST 2016) in Los Angeles.

Exacerbations are the sudden onset of symptoms, such as cough and rapid heartbeat that can make it difficult for people to catch their breath. Anyone with COPD, even those in the early stages of the disease, is vulnerable to experiencing an exacerbation, with the average person experiencing 1 to 3 exacerbations per year. Having even a single exacerbation can damage the lungs, causing the disease to progress faster. Exacerbations, which can last for days, may lead to permanent reductions in lung function, hospitalization or even death. According to one study, 8-12 percent of patients who were hospitalized with an exacerbation died within 30 days.

"Due to the seriousness of exacerbations, healthcare providers develop treatment plans for their patients to reduce the risk of an exacerbation. To do this, healthcare providers must understand the risk factors," said Gary T. Ferguson, MD, Pulmonary Research Institute of Southeast Michigan, Livonia, Michigan, and study investigator. "The new analyses add to the existing research completed to understand exacerbations and underscore the need to remain focused on understanding these potentially harmful complications of COPD."

In the TONADO trials, 1,484 of the 5,162 people with COPD experienced a moderate or severe exacerbation. The analyses show their risk factors were having:

  • An exacerbation in the last year
  • Completed course of antibiotics or intravenous steroids in the past year
  • Had COPD for a longer time than those who didn't have an exacerbation
  • Lower post-bronchodilator lung function (as measured by FEV1) compared to those who didn't have an exacerbation
  • Severe or very severe COPD (GOLD 3/4)

TONADO 1&2 (NCT01431274/NCT01431287) were 52-week, double-blind, parallel-group studies designed to investigate the safety and efficacy of STIOLTO® RESPIMAT® (tiotropium bromide and olodaterol) Inhalation Spray.

Boehringer Ingelheim has initiated a clinical study, DYNAGITO® (NCT02296138), to investigate the potential benefits of STIOLTO RESPIMAT to reduce the risk of exacerbations and improve survival in patients with COPD. This 52-week study involves nearly 8,000 patients in 59 countries.

Long-acting beta2-adrenergic agonists, such as olodaterol, one of the active ingredients in STIOLTO RESPIMAT, increase the risk of asthma-related death. STIOLTO RESPIMAT is not indicated for asthma and should not be initiated in acutely deteriorating COPD patients or for the relief of acute symptoms. STIOLTO RESPIMAT is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, olodaterol, or any component of this product. As with other inhaled medicines, STIOLTO RESPIMAT may cause paradoxical bronchospasm that may be life-threatening. The most common adverse reactions were nasopharyngitis, cough and back pain.

Please see complete Important Safety Information below.

"For more than 40 years, Boehringer Ingelheim has remained committed to scientific research that helps shed light on how to improve outcomes for people living with COPD. Through this new research, we hope to arm healthcare providers with additional information to better predict which of their patients are at risk for a COPD exacerbation," said Danny McBryan, MD, Head, Clinical Development & Medical Affairs, Respiratory, Boehringer Ingelheim Pharmaceuticals, Inc. "We hope to soon announce results from the ongoing Phase III DYNAGITO study, which is exploring the role STIOLTO RESPIMAT could play in the reduction of exacerbations."

About the RESPIMAT InhalerRESPIMAT, the platform inhaler for the Boehringer Ingelheim respiratory therapies, was designed to get medicine deep into patients' lungs as a slow-moving mist. The slow moving mist of the RESPIMAT inhaler provides patients with enough time to breathe in the medication. The RESPIMAT inhaler operates independent of inspiratory effort, helping patients effectively breathe the medicine into their lungs while minimizing inhalation effort.

As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as coordination between actuation of the inhaler and inspiration through the delivery system. The duration of inhalation should be at least as long as the spray duration (1.5 seconds).

Boehringer Ingelheim's RESPIMAT family of products includes four FDA-approved medicines for COPD and asthma.

About COPDChronic obstructive pulmonary disease (COPD) is a term that includes chronic bronchitis and/or emphysema. This disease can make breathing harder because less air is able to flow in and out of the lungs. Chronic lower respiratory diseases, which include COPD, are the third leading cause of death in the United States, and approximately 15 million Americans have been told by a healthcare provider that they have COPD.

The most common symptom of COPD is shortness of breath, especially with physical activities. Coughing, with or without mucus production, is also a common symptom of COPD. These symptoms can be misunderstood as signs of aging. COPD is usually associated with progressive airway damage and loss that cause breathing to get more difficult.

INDICATION for STIOLTO RESPIMAT STIOLTO RESPIMAT (tiotropium bromide and olodaterol) Inhalation Spray is a prescription medicine used long term, two puffs once each day, in controlling symptoms in adults with chronic obstructive pulmonary disease (COPD). COPD is a chronic lung disease that includes chronic bronchitis, emphysema, or both.

STIOLTO contains the anticholinergic, tiotropium, and the long-acting beta2-adrenergic agonist (LABA), olodaterol. STIOLTO works by helping the muscles around the airways in your lungs stay relaxed to prevent symptoms, such as wheezing, cough, chest tightness, and shortness of breath.

STIOLTO is not for treating sudden symptoms of COPD. Always have a rescue medicine with you to treat sudden symptoms. If you do not have a rescue inhaler, contact your healthcare provider to have one prescribed for you.

Do not use STIOLTO if you have asthma. STIOLTO is approved to treat COPD only.

IMPORTANT SAFETY INFORMATIONPeople with asthma who take long-acting beta2-agonist (LABA) medicines, such as olodaterol, (one of the medicines in STIOLTO), have an increased risk of death from asthma problems. It is not known if LABA medicines, such as olodaterol (one of the medicines in STIOLTO), increase the risk of death in people with COPD. STIOLTO has been approved for chronic obstructive pulmonary disease (COPD) only. STIOLTO is NOT to be used in asthma.

Do not use STIOLTO if you are allergic to tiotropium, ipratropium, atropine or similar drugs, olodaterol, or any ingredient in STIOLTO. Symptoms of a serious allergic reaction may include rash, hives, swelling of the face, mouth, and tongue, and breathing problems. Call your healthcare provider or get emergency medical care if you get any symptoms of a serious allergic reaction. Do not use STIOLTO for treating sudden breathing problems. Always have a rescue inhaler with you to treat sudden symptoms.

Do not use STIOLTO more often or at higher doses than prescribed by your doctor. Do not use STIOLTO with other LABAs or anticholinergics. Get emergency medical care if your breathing problems worsen quickly or if you use your rescue inhaler but it does not relieve your breathing problems. Call your healthcare provider if breathing problems worsen over time while using STIOLTO.

Tell your doctor about all your medical conditions including heart problems, high blood pressure, seizures, thyroid problems, diabetes, kidney problems, glaucoma, enlarged prostate, and problems passing urine.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines (including eye drops), vitamins, and herbal supplements. STIOLTO may interact with other medicines which may cause serious side effects.

STIOLTO can cause serious side effects, including sudden shortness of breath that may be life threatening, fast or irregular heartbeat, increased blood pressure, chest pain, high blood sugar, or low blood potassium that may cause muscle spasms or weakness or abnormal heart rhythm. If any of these happens, stop taking STIOLTO and seek immediate medical help.

STIOLTO can cause new or worsening eye problems including narrow-angle glaucoma, and can increase the pressure in your eyes, which can cause the following symptoms: eye pain, blurred vision, seeing halos or colored images along with red eyes. If you have any of these symptoms, stop taking your medicine and call your doctor right away.

STIOLTO can cause new or worsened urinary retention. Symptoms of urinary retention may include difficulty passing urine, painful urination, urinating frequently, or urinating in a weak stream or drips. If you have any of these symptoms, stop taking your medicine and call your doctor right away.

STIOLTO is for oral inhalation only. The STIOLTO cartridge is only intended for use with the STIOLTO RESPIMAT inhaler.

Do not spray STIOLTO into your eyes.

The most common side effects of STIOLTO are runny nose, cough, and back pain.

Tell your healthcare provider about any side effect that bothers you or that does not go away.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Read the step-by-step patient Instructions for Use for STIOLTO RESPIMAT before you use your inhaler.

Please see accompanying Medication Guide, Instructions for Use, and Full Prescribing Information, including boxed WARNING.

About Boehringer Ingelheim Pharmaceuticals, Inc.Boehringer Ingelheim Pharmaceuticals, Inc., based in Ridgefield, CT, is the largest U.S. subsidiary of Boehringer Ingelheim Corporation.

Boehringer Ingelheim is one of the world's 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, the company operates globally with 145 affiliates and more than 47,000 employees. Since its founding in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel treatments for human and veterinary medicine.

Boehringer Ingelheim is committed to improving lives and providing valuable services and support to patients and their families. Our employees create and engage in programs that strengthen our communities. To learn more about how we make more health for more people, visit our Corporate Social Responsibility Report.

In 2015, Boehringer Ingelheim achieved net sales of about $15.8 billion (14.8 billion euros). R&D expenditure corresponds to 20.3 percent of its net sales.

For more information please visit, or follow us on Twitter @BoehringerUS.

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SOURCE Boehringer Ingelheim Pharmaceuticals



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