Evidence map›Paper›PMID 32848380›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2020

No Influence on Cardiac Arrhythmia or Heart Rate from Long-Term Treatment with Tiotropium/Olodaterol versus Monocomponents by Holter ECG Analysis in Patients with Moderate-to-Very-Severe COPD.

Stefan Andreas, Ulrich Bothner, Alberto de la Hoz, Isabel Kloer, Matthias Trampisch, Peter Alter

2 registry-linked trialsOpen access · goldAbstract read
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01431274 phase3completednot on this map

A Randomised, Double-blind, Parallel Group Study to Assess the Efficacy and Safety of 52 Weeks of Once Daily Treatment of Orally Inhaled Tiotropium + Olodaterol Fixed Dose Combination (2.5 µg / 5 µg; 5 µg / 5 µg) (Delivered by the Respimat® Inhaler) Compared With the Individual Components (2.5 µg and 5 µg Tiotropium, 5 µg Olodaterol) (Delivered by the Respimat® Inhaler) in Patients With Chronic Obstructive Pulmonary Disease (COPD). [TOnado TM 1]

TypeinterventionalSponsorBoehringer IngelheimRan2011 to 2013Enrolled2,624ConditionsPulmonary Disease, Chronic ObstructiveArmstiotropium + olodaterol, tiotropium, olodaterol, Respimat
NCT01431287 phase3completednot on this map

A Randomised, Double-blind, Parallel Group Study to Assess the Efficacy and Safety of 52 Weeks of Once Daily Treatment of Orally Inhaled Tiotropium + Olodaterol Fixed Dose Combination (2.5 µg / 5 µg; 5 µg / 5 µg) (Delivered by the Respimat® Inhaler) Compared With the Individual Components (2.5 µg and 5 µg Tiotropium, 5 µg Olodaterol) (Delivered by the Respimat® Inhaler) in Patients With Chronic Obstructive Pulmonary Disease (COPD) [TOnado TM 2]

TypeinterventionalSponsorBoehringer IngelheimRan2011 to 2013Enrolled2,539ConditionsPulmonary Disease, Chronic ObstructiveArmstiotropium + olodaterol, tiotropium, olodaterol, Respimat
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Effects of LAMA/LABA Alone and in Combination on Cardiac Safety.International journal of chronic obstructive pulmonary disease · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Stefan AndreasDepartment of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.ORCID 0000-0003-3918-6909
Ulrich BothnerBoehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Alberto de la HozBoehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Isabel KloerBoehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Matthias TrampischBoehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Peter AlterDepartment of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), Marburg, Germany, Member of the German Center for Lung Research (DZL).ORCID 0000-0002-2115-1743
Boehringer Ingelheim (Germany) · DEPhilipps University of Marburg · DEUniversitätsmedizin Göttingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) and cardiovascular comorbidities may have an increased risk of medication-related cardiac arrhythmias. We therefore performed an analysis of Holter electrocardiogram (ECG) data from two large, long-term, controlled clinical COPD trials to investigate whether tiotropium/olodaterol increased the risk of cardiac arrhythmia and mean heart rate. Methods: We analyzed Holter ECG data from a representative subset of patients (N=506) from the two pooled replicate studies (TONADO 1 and 2) assessing tiotropium/olodaterol 5/5 µg therapy versus tiotropium 5 µg or olodaterol 5 µg monotherapy, inhaled once daily (two single inhalations) using the Respimat Results: After 12 weeks of treatment, there was no difference in the number of patients who had an increase or decrease from baseline in 24-hour supraventricular premature beats or ventricular premature beats between tiotropium/olodaterol 5/5 µg combination therapy and its monocomponents. Compared with baseline, a small but statistically significant increase in adjusted mean heart rate was observed for tiotropium 5 µg (+1.6 beats per minute [bpm]; P=0.0010), but no difference was observed for olodaterol 5 µg (+0.3 bpm; P=0.2778) or tiotropium/olodaterol 5/5 µg (-0.1 bpm; P=0.4607). MACE and fatal MACE were limited to 1 to 3 patients across treatment groups. Conclusion: Compared with the compounds given as monotherapy, treatment with tiotropium/olodaterol fixed-dose combination therapy is not associated with medically relevant or statistically significant effects on arrhythmia as assessed by Holter ECG. Based on these findings, there is no evidence to assume a clinically relevant impact on cardiac function from dual tiotropium/olodaterol treatment. Trial Registration: TONADO 1 (ClinicalTrials.gov: NCT01431274); TONADO 2 (ClinicalTrials.gov: NCT01431287).

Indexed as

Electrocardiography, AmbulatoryPulmonary Disease, Chronic ObstructiveAdministration, InhalationArrhythmias, CardiacBenzoxazinesBronchodilator AgentsDouble-Blind MethodForced Expiratory VolumeHeart RateHumansTiotropium BromideTreatment OutcomeBenzoxazinesBronchodilator AgentsolodaterolTiotropium Bromidearrhythmiaheart rateHolter ECGolodaterolsafetytiotropium

Identifiers

PMID32848380
PMCPMC7429402
OpenAlexW3047830947

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.