This article is part of Pulmonology Advisor‘s coverage of the American Thoracic Society International Conference, taking place in Dallas, Texas. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from ATS 2019.

DALLAS — Once-daily umeclidinium improved all lung function measures compared with twice-daily salmeterol in patients with chronic obstructive pulmonary disease (COPD) who were naive to maintenance therapy or who were treated with a single maintenance bronchodilator, according to the results of a study presented at the American Thoracic Society International Conference, held May 17-22, in Dallas, Texas.

Maintenance-naive or single maintenance bronchodilator-treated patients with COPD enrolled in the Early Maximization of Bronchodilation for Improving COPD Stability (EMAX) trial were randomly assigned to receive either once-daily umeclidinium (62.5 mcg) or twice-daily salmeterol (50 mcg). Functional respiratory measures and risk for a first COPD exacerbation were compared between the 2 groups.

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Of the 1613 patients enrolled in the study, 804 and 809 patients received umeclidinium and salmeterol, respectively. Ultimately, patients taking once-daily umeclidinium showed significantly greater improvement in lung function across all time points and measurements compared with those taking twice-daily salmeterol (P <.001). More patients in the umeclidinium group were responders according to the St. George’s Respiratory Questionnaire compared with those in the salmeterol group (41% vs 36%, respectively), but the number of responders for other patient-reported outcomes were similar between the treatments.

Furthermore, fewer patients receiving umeclidinium than salmeterol experienced an on-treatment exacerbation; although this difference did not reach statistical significance.

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Kerwin EM, Vogelmeier C, Bjermer L, et al. Comparative efficacy of once- daily umeclidinium and twice-daily salmeterol in symptomatic patients with chronic obstructive pulmonary disease free of inhaled corticosteroids: results from the EMAX trial. Presented at: the American Thoracic Society International Conference; May 20, 2019; Dallas, TX. Abstract A3320/P509.