Introduction: Exercise limitation, dynamic hyperinflation, and exertional dyspnea are key
features of symptomatic chronic obstructive pulmonary disease (COPD). We assessed the effects
of glycopyrronium bromide (NVA237), a once-daily, long-acting muscarinic antagonist, on
exercise tolerance in patients with moderate to severe COPD.
Methods: Patients were randomized to a cross-over design of once-daily NVA237 50 µg or
placebo for 3 weeks, with a 14-day washout. Exercise endurance, inspiratory capacity (IC)
during exercise, IC and expiratory volumes from spirometry, plethysmographic lung volumes,
leg discomfort and dyspnea under exercise (Borg scales), and transition dyspnea index were
measured on Days 1 and 21 of treatment. The primary endpoint was endurance time during a
submaximal constant-load cycle ergometry test on Day 21.