One-year analysis of longitudinal changes in spirometry in patients with COPD receiving tiotropium

Airway medications have not been shown to reduce the loss of lung function in patients with COPD. We explored whether tiotropium 18μg once daily could slow the rate of decline of lung function over a 1-year period. We performed a post-hoc analysis of data from 921 ambulatory COPD patients participat...

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Bibliographic Details
Published in:Pulmonary pharmacology & therapeutics 2005-04, Vol.18 (2), p.75-81
Main Authors: Anzueto, A., Tashkin, D., Menjoge, S., Kesten, S.
Format: Article
Language:English
Subjects:
Administration, Inhalation
Adrenal Cortex Hormones - therapeutic use
Aged
Bronchodilator Agents - therapeutic use
Chronic obstructive pulmonary disease
Female
FEV1
Forced Expiratory Volume - physiology
Humans
Lung function
Male
Pulmonary Disease, Chronic Obstructive - drug therapy
Pulmonary Disease, Chronic Obstructive - physiopathology
Randomized Controlled Trials as Topic
Retrospective Studies
Scopolamine Derivatives - therapeutic use
Smoking - physiopathology
Spirometry
Tiotropium
Tiotropium Bromide
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Summary:Airway medications have not been shown to reduce the loss of lung function in patients with COPD. We explored whether tiotropium 18μg once daily could slow the rate of decline of lung function over a 1-year period. We performed a post-hoc analysis of data from 921 ambulatory COPD patients participating in two, 1-year, double-blind, tiotropium vs. placebo-controlled trials. Serial spirometry was obtained at baseline (before first dose of study drug), on day 8, at 6 weeks, and at 3, 6, 9 and 12 months after start of the study. Baseline demographics and lung function were comparable. Baseline FEV1 was 1.01±0.41 (SD) L (39±14% predicted). Mean decline in trough FEV1 (i.e. FEV1 23–24h after prior use of medication) between days 8 and 344 was 58ml/year in the placebo group and 12ml/year in the tiotropium group (p=0.005 vs. placebo); and between days 50 and 344 was 59ml/year in the placebo group and 19ml/year in the tiotropium group (p=0.036 vs. placebo). Based on a retrospective analysis of 1-year, placebo-controlled clinical trials, tiotropium was associated with a reduced rate of loss of FEV1. Longer-term trials specifically designed to study this effect are required to confirm this observation.
ISSN:1094-5539
1522-9629
DOI:10.1016/j.pupt.2004.10.003