Effect of evening vs. morning LAMA administration on risk of intensive care admission in COPD patients…

Randomized trialEuropean clinical respiratory journal· 2026

Effect of evening vs. morning LAMA administration on risk of intensive care admission in COPD patients: influence of adherence post hoc analysis of the randomized controlled trial - LAMA BY NIGHT.

Pradeesh Sivapalan, Anna Kubel Vognsen, Valdemar Rømer … Jens-Ulrik Stæhr Jensen

Pulmonology & Critical CareRandomized trialClinical practiceQ3IF 1.7

Evening LAMA dosing did not significantly reduce ICU admission risk in COPD patients

Effect of evening vs. morning LAMA administration on risk of intensive care admission in COPD patients: influence of adherence post hoc analysis of the randomized controlled trial - LAMA BY NIGHT.

Pradeesh Sivapalan … Jens-Ulrik Stæhr Jensen

European clinical respiratory journal · 2026

Background

The timing of LAMA administration, prescribed for morning dosing, has been questioned, particularly given the nocturnal symptoms many COPD patients experience.

Purpose

To determine whether the administration timing of LAMA affects the risk of ICU admission for COPD patients.

Methods

The LAMA BY NIGHT trial was a digital, multicenter, randomized, open-label study that enrolled 10,011 COPD patients.

n = 6,747 patients

Results

evening dosing showed no clear ICU benefit over morning dosing

RR 0.77 (95% CI 0.61 to 1.55)

CI crosses the null - not significant

More results

At 6 months, 6,747 patients (67%) completed follow-up questionnaires, of whom 80% were adherent.

At 12 months, ICU admissions were similar between groups (RR = 0.97, CI = (0.40-1.50), p = 1.00).

Likewise, non-adherent patients showed no significant difference in ICU admissions between morning and evening dosing at 6 months or 12 months.

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Conclusion

In this post hoc analysis of the LAMA BY NIGHT trial, evening administration of LAMA did not reduce the risk of ICU admissions among patients with COPD, and adherence to the assigned dosing schedule did not modify this association.

Effect of evening vs. morning LAMA administration on risk of intensive care admission in COPD patients: influence of adherence post hoc analysis of the randomized controlled trial - LAMA BY NIGHT.

Effect of evening vs. morning LAMA administration on risk of intensive care admission in COPD patients: influence of adherence post hoc analysis of the randomized controlled trial - LAMA BY NIGHT.

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