Abstract
Aim:
To assess the effect of tiotropium 18mcg once daily on chronic obstructive pulmonary disease (COPD) exacerbations and exacerbation-related hospitalisations using a patient-level pooled analysis.
Methods:
All completed randomised, placebo-controlled, parallel-group tiotropium trials with a duration of ≥24 weeks were included (n=9). An exacerbation was defined in each study as ≥2 respiratory symptoms lasting ≥3 days, and requiring treatment with antibiotics and/or systemic steroids and/or hospitalisation.
Results:
Compared with placebo (2,862 patients), tiotropium (3,309 patients) significantly reduced by 21% both the risk of COPD exacerbation (95% confidence interval [CI] 0.73–0.86; p<0.0001) and the risk of exacerbation-associated hospitalisation (95% CI 0.65–0.96; p=0.015). Time to first exacerbation and first associated hospitalisation were increased. The protective effect of tiotropium was consistent regardless of age, gender, inhaled corticosteroid use and disease severity.
Conclusion:
This analysis provides further confirmatory evidence that tiotropium reduces the risk of exacerbation and associated hospitalisation.
Keywords: COPD, exacerbations, hospitalisations, pooled analysis, tiotropium
Full Text
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Footnotes
Dr D Halpin has received reimbursement for attending a symposium and a fee for speaking from Boehringer Ingelheim GmbH and Pfizer Inc. Drs S Menjoge and K Viel are both employees of Boehringer Ingelheim GmbH, the manufacturer of tiotropium (Spiriva*).