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Tiotropium Reduces Exacerbations and Associated Health Resource use in Patients With COPD

PARIS, FRANCE -- March 7, 2006 -- New data from a large one-year study published in this month's issue of the European Respiratory Journal show that tiotropium significantly reduces exacerbations and associated health resource use in patients with COPD compared with placebo(1).

Tiotropium (SpirivaŽ) is an anticholinergic medication recommended for maintenance treatment of patients with COPD(2).

COPD is a progressive respiratory illness that causes significant deterioration of lung function and chronic breathlessness(2). 600 million people worldwide already live with COPD, but its prevalence is predicted to rise to become the world's third leading cause of death by 2020(3),(4).

Exacerbations of COPD, a major cause of death and disability, are characterised by an acute worsening of symptoms and, over time, cause a deterioration in lung function(5). Preventing and treating exacerbations is a key goal of COPD treatment(2) as they have a profound impact on a patient's quality of life and often result in the need for additional medication and hospitalisation, adding to the already high financial cost of treating COPD(6).

"These study results are very good news for both patients and their healthcare providers", said Prof. Dusser, Head of Pneumology, Hopital Cochin, Paris and principal study investigator. "Treatments for COPD that can reduce the frequency or severity of exacerbations and associated health resource use can have a significant impact on both patients' quality of life and the cost of treatment. This study has shown that, with tiotropium, we have an effective treatment option to achieve this".

The study was a one-year randomised, double-blind, parallel group study involving 1,010 patients from 177 centres in France. Compared with placebo, treatment with tiotropium(1):

- significantly delayed the time to first exacerbation by about 100 days (P <.001)

- reduced the proportion of patients experiencing more that one exacerbation by 17% (P <.01)

- decreased number of exacerbations by 35% (P <.001) and exacerbations days by 37% (P <.001)

- decreased health-resource use, including a reduction in the number of unscheduled physician visits by 41% and phone calls to a physician by 53% (P <.05) and also a reduction in concomitant respiratory medications, antibiotics and oral steroids (P <.0001).

Treatment also significantly improved airflow in patients over one year compared with placebo, as measured by a significant improvement in (trough) pre-dose FEV1 (forced expiratory volume in one second).

REFERENCES:
1. Dusser D, Bravo M-L, Iacono P on behalf of the MISTRAL study group. Eur Respr J 2006; 27:547-555.

2. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Executive Summary. GOLD website (http://www.goldcopd.com). Updated 2005.

3. World Health Organization. World Health Report 2004. Statistical Annex. Annex table 2 and 3: 120-131.

4. Murray CJL, Lopez AD. eds. The Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge; Harvard University Press; 1996.

5. Wedzicha JA, Donaldson GC. Respir Care 2003; 48:1204-1213.

6. Seemungal TAR, Donaldson GC, Bhowmik A et al. Am J Respir Crit Care Med 2000; 161:1608-1613.


SOURCE: Hospital Cochin

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