PT  - JOURNAL ARTICLE
AU  - W. Vincken
AU  - J.A. van Noord
AU  - A.P.M. Greefhorst
AU  - Th.A. Bantje
AU  - S. Kesten
AU  - L. Korducki
AU  - P.J.G. Cornelissen
TI  - Improved health outcomes in patients with COPD during 1 yr's treatment with tiotropium
AID  - 10.1183/09031936.02.00238702
DP  - 2002 Feb 01
TA  - European Respiratory Journal
PG  - 209--216
VI  - 19
IP  - 2
4099  - http://erj.ersjournals.com/content/19/2/209.short
4100  - http://erj.ersjournals.com/content/19/2/209.full
SO  - Eur Respir J2002 Feb 01; 19
AB  - Tiotropium, a novel once-daily inhaled anticholinergic, has been shown to improve lung function over a 24-h period. In order to extend these findings, health-outcomes were evaluated over 1 yr in chronic obstructive pulmonary disease (COPD) patients. Spirometric results, peak expiratory flow rate (PEFR), salbutamol use and effects on dyspnoea, health-related quality of life and COPD exacerbations were assessed in two identical 1-yr randomized double-blind double-dummy studies of tiotropium 18µg once daily (n=356) compared with ipratropium 40µg q.i.d. (n=179). Screening forced expiratory volume in one second (FEV1) were 1.25±0.43 L (41.9±12.7% of the predicted value) (tiotropium) and 1.18±0.37 L (39.4±10.7% pred) (ipratropium). Trough FEV1 at 1 yr improved by 0.12±0.01 L with tiotropium and declined by 0.03±0.02 L with ipratropium (p<0.001). Significant improvement in PEFR, salbutamol use, Transition Dyspnea Index focal score, and the St George's Respiratory Questionnaire total and impact scores were seen with tiotropium (p<0.01). Tiotropium reduced the number of exacerbations (by 24%, p<0.01), and increased time to first exacerbation (p<0.01) and time to first hospitalization for a COPD exacerbation (p<0.05) compared with ipratropium. Apart from an increased incidence of dry mouth in the tiotropium group, adverse events were similar between treatments. Tiotropium was effective in improving dyspnoea, exacerbations, health-related quality of life and lung function in patients with chronic obstructive pulmonary disease, and exceeds the benefits seen with ipratropium. The data support the use of tiotropium once-daily as first-line maintenance treatment in patients with chronic obstructive pulmonary disease.