About Careers MedBlog Contact us

Tiotropium and Olodaterol in COPD: Disadvantages in Some, Advantages in Others

by Dr. Trupti Shirole on November 27, 2015 at 10:16 AM
Font : A-A+

 Tiotropium and Olodaterol in COPD: Disadvantages in Some, Advantages in Others

Chronic obstructive pulmonary disease (COPD) is a progressive disease that makes it hard to breathe. The fixed-dose combination of tiotropium and olodaterol (trade name: Spiolto Respimat) has been approved since July 2015 for maintenance treatment in adults with COPD. The German Institute for Quality and Efficiency in Health Care (IQWiG) examined in a dossier assessment whether this drug combination offers an added benefit over the appropriate comparator therapy.

The findings revealed that there were no statistically significant differences between the treatment groups for the totality of adults with moderate COPD symptoms (severity grade II) and higher severity grades (III-IV) and fewer than two flare-ups (exacerbations) per year. Indications of a minor added benefit could only be derived for women in these COPD groups who inhaled the fixed-dose combination.


In adults with higher severity grades (< III) and at least two flare-ups per year, even disadvantages occurred, which resulted in proof of lesser benefit.

The Federal Joint Committee (G-BA) specified different appropriate comparator therapies depending on the severity of the disease- From a moderate COPD severity grade (stage II), the new drug combination was to be compared with a long-acting beta-2 sympathomimetic (LABA, e.g. formoterol, salmeterol) and/or tiotropium (research question 1). From severity grade III and at least two flare-ups (exacerbations) per year, the patients in the comparator arm were to receive an additional inhaled corticosteroid (ICS) (research question 2).

The manufacturer presented data from two approval studies (TONADO 1 and 2) with patients diagnosed with moderate to severe COPD. In contrast to the G-BA's specifications, all patients included in these studies could continue ongoing treatment with an ICS. Hence for both research questions, the assessment was based on subpopulations treated in compliance with the G-BA specifications.

The average age of the patients in the subpopulations was 60 years, and the majority were men: depending on the subpopulation, there were twice to four times as many men as women.

For maintenance treatment in a chronic disease, such as tiotropium/olodaterol, analyses over a longer period of time are more suitable for drawing conclusions on long-term effects. Analyses after 52 weeks were therefore used for all outcomes in the present assessment. The manufacturer, in contrast, had also considered analyses after week 24 in some outcomes.

For most adults in the subpopulation with severity grade II or severity grade III and IV with fewer than two exacerbations per year, no relevant differences between the treatment groups were shown, or data were lacking, for most outcomes (e.g. COPD symptoms, exacerbations, quality of life, severe side effects).

Positive effects regarding health-related quality of life and COPD symptoms (shortage of breath) under the fixed-dose combination were only shown for women in this subpopulation. In each case, an indication of minor added benefit of tiotropium/olodaterol in comparison with tiotropium can be derived from this. The data provided neither positive nor negative effects for men.

No relevant differences between the treatment groups occurred or data were lacking also for the second research question (adults with severity grade higher than III and at least two exacerbations per year) in most outcomes.

However, severe exacerbations were more frequent in patients who had inhaled the fixed-dose combination. This resulted in proof of lesser benefit of tiotropium/olodaterol plus ICS in comparison with tiotropium plus ICS.

This dossier assessment is part of the early benefit assessment according to the Act on the Reform of the Market for Medicinal Products (AMNOG) supervised by the G-BA. After publication of the dossier assessment, the G-BA conducts a commenting procedure and makes a final decision on the extent of the added benefit.

Source: Eurekalert


Latest Drug News

 Understanding Why Aspirin is a Magic Drug for Inflammation
New discoveries about aspirin's interplay between messenger molecules that are crucial in the inflammatory proves again that it is a powerful anti-inflammatory drug.
Is Fomepizole the Key to Overcoming Antibiotic-Resistant Pneumonia?
The new drug target sheds insights into strategies to fight drug-resistant S. pneumoniae, stated research.
 Combination Therapy Benefits Septic Shock Patients
The effectiveness of adding fludrocortisone to hydrocortisone vs hydrocortisone alone among patients with septic shock was analyzed using target trial emulation.
Are Painkillers Safe for Back Pain?
Safety and effectiveness of commonly used painkillers (analgesics) for short-term relief of low back pain remain uncertain.
 India's First Urinary Incontinence Drug Launched
India's First Urinary Incontinence Drug Fesobig may offer Affordable treatment for Overactive Bladder (OAB), a widely prevalent problem among Indian men and women.
View All
This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use  Ok, Got it. Close

Tiotropium and Olodaterol in COPD: Disadvantages in Some, Advantages in Others Personalised Printable Document (PDF)

Please complete this form and we'll send you a personalised information that is requested

You may use this for your own reference or forward it to your friends.

Please use the information prudently. If you are not a medical doctor please remember to consult your healthcare provider as this information is not a substitute for professional advice.

Name *

Email Address *

Country *

Areas of Interests