TY - JOUR
T1 - Tiotropium as a first maintenance drug in COPD: secondary analysis of the UPLIFT trial
AU - Troosters, T
AU - Celli, B
AU - Lystig, T
AU - Kesten, S
AU - Mehra, S
AU - Tashkin, D P
AU - Decramer, M
AU - Uplift Investigators
AU - Backer, Vibeke
PY - 2010/7/1
Y1 - 2010/7/1
N2 - The aim of the present study was investigate the long-term effect of tiotropium as first maintenance respiratory medication in chronic obstructive pulmonary disease (COPD). A 4-yr, randomised, multicentre, double-blind, parallel-group, placebo-controlled trial (Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT®)) was conducted. Analysis focused on the effect of tiotropium versus matching placebo in the 810 (13.5%) COPD patients not on other maintenance treatment (long-acting b-agonists, inhaled corticosteroids, theophyllines or anticholinergics) at randomisation. Spirometry, health-related quality of life (St George's Respiratory Questionnaire (SGRQ) score), exacerbations of COPD and mortality were also analysed. 403 patients (mean±SD age 63±8 yrs, post-bronchodilator forced expiratory volume in 1 s (FEV1) 53±12% predicted) received tiotropium and 407 (64±8 yrs of age, post-bronchodilator FEV1 51±12% pred) received placebo. Post-bronchodilator FEV1 decline was 42±4 mL·yr-1 in the tiotropium group and 53±4 mL·yr-1 in the placebo group (p=0.026). At 48 months, the morning pre-dose FEV1 was 134 mL higher in the tiotropium group compared to the placebo group (p<0.001). SGRQ total score declined more slowly in the tiotropium group (difference of 1.05±0.34 units·yr-1; p=0.002). This was particularly significant for the impact (difference of 1.08±0.37 units·yr -1; p=0.004) and activity (1.44±0.40 units·yr -1; p<0.001) domains, but not for symptoms (0.26±0.50 units·yr-1; p=0.6). At 48 months, the difference in total score was 4.6 units (p<0.001) with tiotropium compared to placebo. In patients with COPD who are not on maintenance therapy, tiotropium is associated with significant benefits in disease progression. Copyright
AB - The aim of the present study was investigate the long-term effect of tiotropium as first maintenance respiratory medication in chronic obstructive pulmonary disease (COPD). A 4-yr, randomised, multicentre, double-blind, parallel-group, placebo-controlled trial (Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT®)) was conducted. Analysis focused on the effect of tiotropium versus matching placebo in the 810 (13.5%) COPD patients not on other maintenance treatment (long-acting b-agonists, inhaled corticosteroids, theophyllines or anticholinergics) at randomisation. Spirometry, health-related quality of life (St George's Respiratory Questionnaire (SGRQ) score), exacerbations of COPD and mortality were also analysed. 403 patients (mean±SD age 63±8 yrs, post-bronchodilator forced expiratory volume in 1 s (FEV1) 53±12% predicted) received tiotropium and 407 (64±8 yrs of age, post-bronchodilator FEV1 51±12% pred) received placebo. Post-bronchodilator FEV1 decline was 42±4 mL·yr-1 in the tiotropium group and 53±4 mL·yr-1 in the placebo group (p=0.026). At 48 months, the morning pre-dose FEV1 was 134 mL higher in the tiotropium group compared to the placebo group (p<0.001). SGRQ total score declined more slowly in the tiotropium group (difference of 1.05±0.34 units·yr-1; p=0.002). This was particularly significant for the impact (difference of 1.08±0.37 units·yr -1; p=0.004) and activity (1.44±0.40 units·yr -1; p<0.001) domains, but not for symptoms (0.26±0.50 units·yr-1; p=0.6). At 48 months, the difference in total score was 4.6 units (p<0.001) with tiotropium compared to placebo. In patients with COPD who are not on maintenance therapy, tiotropium is associated with significant benefits in disease progression. Copyright
U2 - http://dx.doi.org/10.1183/09031936.00127809
DO - http://dx.doi.org/10.1183/09031936.00127809
M3 - Journal article
SN - 0904-1850
VL - 36
SP - 65
EP - 73
JO - Acta tuberculosea Scandinavica
JF - Acta tuberculosea Scandinavica
IS - 1
ER -