Results A total of 116 patients (mean [SD] age of 67  years, 53% female, mean BMI of [IQR, -], mean [SD] forced expiratory volume in the first second of expiration of L [ L], and mean [SD] Pa co 2 while breathing room air of 59  mm Hg) were randomized. Sixty-four patients (28 in home oxygen alone and 36 in home oxygen plus home NIV) completed the 12-month study period. The median time to readmission or death was months (IQR, - months) in the home oxygen plus home NIV group vs months (IQR, - months) in the home oxygen alone group, adjusted hazard ratio of (95% CI, -; P = .002). The 12-month risk of readmission or death was % in the home oxygen plus home NIV group vs % in the home oxygen alone group, absolute risk reduction of % (95% CI, %-%). At 12 months, 16 patients had died in the home oxygen plus home NIV group vs 19 in the home oxygen alone group.