Late Breaking Abstract - Evening Administration of Long-Acting Muscarinic Antagonists in Chronic Obstructive Pulmonary Disease to Prevent Exacerbations

Pradeesh Sivapalan, Valdemar Rømer, Alexander Jordan, Niklas Dyrby Johansen, Manan Pareek, Daniel Modin, Alexander Mathioudakis, Jørgen Vestbo, Josefin Eklöf, John R Hurst, Tobias Wirenfeldt Klausen, Tor Biering-sørensen, Jens-ulrik Stæhr Jensen

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskning

Abstract

Background: For once daily Long-acting muscarinic antagonists (LAMA) products, morning administration is recommended. Night-time parasympathetic activation combined with the less potent effect of LAMA closer to end of the dosing period suggests greater benefits of evening LAMA-administration.

Aims: To determine whether evening LAMA administration reduces the risk of hospitalization-requiring chronic obstructive pulmonary disease (COPD) exacerbations or all-cause mortality within one year, compared with morning dosing.

Methods: In this randomized controlled, digital platform, pragmatic trial, we used a secure digital mailbox system to invite all Danish COPD patients who used a once-daily LAMA. Danish health registers ensured complete follow-up.

Results: We enrolled 10,011 COPD patients using once-daily LAMA, randomly assigning evening (n=5,028) or morning (n=4,983) administration. In the evening-LAMA group, 245 persons (5%) met the primary outcome compared with 249 persons (5%) in the morning-LAMA group. No difference was found for the primary outcome(P=0.93). Evening LAMA reduced the risk of ICU admission(P=0.0077). There was no difference between groups in the incidence of moderate COPD exacerbation(P=0.52), NIV(P=0.51), or all-cause mortality(P=0.57).

Conclusions: Evening LAMA administration in COPD patients is safe and may be beneficial in COPD-patients at high risk of ICU admission.
OriginalsprogEngelsk
TidsskriftThe European Respiratory Journal
Vol/bind64
Udgave nummerSuppl 68
Sider (fra-til)PA2529
Antal sider1
ISSN0903-1936
DOI
StatusUdgivet - 2024

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