Health outcomes following treatment for six months with once daily tiotropium compared with twice daily salmeterol in patients with COPD

• Published in: Thorax 2003-05, Vol.58 (5), p.399-404
• Main Authors: BRUSASCO, V, HODDER, R, MIRAVITLLES, M, KORDUCKI, L, TOWSE, L, KESTEN, S
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Albuterol - administration & dosage; Albuterol - analogs & derivatives; Biological and medical sciences; Bronchodilator Agents - administration & dosage; Chronic Obstructive Pulmonary Disease; Dosage and administration; Double-Blind Method; Drug therapy; Dyspnea - etiology; Evaluation; Female; Forced Expiratory Volume - drug effects; Hospitalization - statistics & numerical data; Humans; Lung diseases, Obstructive; Male; Medical sciences; Metered Dose Inhalers; Middle Aged; Parasympatholytic agents; Patient outcomes; Pharmacology. Drug treatments; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - physiopathology; Quality of Life; Respiratory system; Salmeterol; Salmeterol Xinafoate; Scopolamine Derivatives - administration & dosage; Tiotropium Bromide; Vital Capacity - drug effects
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.58.5.399

A study was undertaken to record exacerbations and health resource use in patients with COPD during 6 months of treatment with tiotropium, salmeterol, or matching placebos. Patients with COPD were enrolled in two 6-month randomised, placebo controlled, double blind, double dummy studies of tiotropium 18 micro g once daily via HandiHaler or salmeterol 50 micro g twice daily via a metered dose inhaler. The two trials were combined for analysis of heath outcomes consisting of exacerbations, health resource use, dyspnoea (assessed by the transitional dyspnoea index, TDI), health related quality of life (assessed by St George's Respiratory Questionnaire, SGRQ), and spirometry. 1207 patients participated in the study (tiotropium 402, salmeterol 405, placebo 400). Compared with placebo, tiotropium but not salmeterol was associated with a significant delay in the time to onset of the first exacerbation. Fewer COPD exacerbations/patient year occurred in the tiotropium group (1.07) than in the placebo group (1.49, p