PT - JOURNAL ARTICLE AU - David Halpin AU - Marc Decramer AU - Bart Celli AU - Antonio Martín AU - Inge Leimer AU - Norbert Metzdorf AU - Donald Tashkin TI - Effectiveness of tiotropium in low-risk patients according to new GOLD severity grading DP - 2012 Sep 01 TA - European Respiratory Journal PG - P2190 VI - 40 IP - Suppl 56 4099 - http://erj.ersjournals.com/content/40/Suppl_56/P2190.short 4100 - http://erj.ersjournals.com/content/40/Suppl_56/P2190.full SO - Eur Respir J2012 Sep 01; 40 AB - Background: GOLD recently updated their COPD severity classification to include risk of exacerbations. Increased risk is typically defined by a FEV1 of <50% pred and/or ≥2 exacerbations in the previous year (C+D) and low risk by a FEV1 ≥50% pred and 0-1 exacerbation in the previous year (A+B).Aims and objectives: To examine the effect of tiotropium 18 µg qd via Handihaler® in GOLD low risk patients (pts) using data from a 4-y, randomized, double-blind, placebo-controlled trial in COPD (UPLIFT®).Methods: Retrospective analysis of exacerbations, lung function and QoL (SGRQ) in low-risk pts (pts with a baseline postbronchodilator [BD] FEV1 %pred ≥50% and ≤1 oral steroid/antibiotic course in the previous year). Pts with high risk (FEV1 %pred <50% or more than 1 course of oral steroids/antibiotics) were also analyzed.Results: 2012 pts were analyzed (mean age 64.5±8.6 y, male 74%, mean (±SD) baseline postBD FEV1 1.65 (0.37) L and FEV1 %pred (±SD) 58.9 (5.8). The HR (tiotropium vs control) for time to first exacerbation was 0.76 (95% CI, 0.68; 0.86; P<0.0001); mean annual exacerbation rates were 0.43 (95% CI, 0.40; 0.48) vs 0.61 (0.56; 0.66), rate ratio 0.72 (0.63; 0.81; P<0.0001). The SGRQ total score after 4 y was significantly improved by tiotropium vs placebo: −3.63 (95% CI, −5.14; −2.12; P<0.0001) and the respective increase for trough FEV1 was 110 mL (95% CI, 84; 136; P<0.0001). SGRQ and trough FEV1 were significantly improved at all time points. The above-mentioned endpoints were also significantly improved in the high-risk population.Conclusion: Tiotropium qd was effective throughout 4 y in reducing exacerbations and improving lung function and QoL in low-risk pts with COPD (GOLD A+B).