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Long-Term Treatment With Tiotropium Is Effective for Men, Women With COPD: Presented at CHEST 2009

By Betty S. Riggs

SAN DIEGO -- November 6, 2009 -- Long-term treatment with tiotropium improves lung function, exacerbation of disease, and health-related qualify of life in both men and women with chronic obstructive pulmonary disease (COPD), according to results of a study presented here at CHEST 2009, the annual meeting of the American College of Chest Physicians.

Donald P. Tashkin, MD, Pulmonary Function Laboratory, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, and colleagues reported their findings here on November 3.

The Understanding Potential Long-Term Impacts on Function With Tiotropium (UPLIFT) trial was a 4-year, randomised, double-blind, placebo-controlled trial of tiotropium in patients with COPD.

Patients (n = 5,992) who qualified were randomised to receive placebo or tiotropium 18 mcg once daily, delivered via inhalation device. Patients were allowed to use all respiratory medications, except inhaled anticholinergic drugs, in addition to study drug.

Coprimary endpoints were rate of decline in the mean forced expiratory volume in the first second of expiration (FEV₁) before and after bronchodilator (BD) beginning on day 30. Secondary endpoints included spirometry measurements, exacerbation of disease, health-related quality of life as measured by the St. George's Respiratory Questionnaire (SGRQ), and mortality.

The purpose of the current analysis was to examine the influence of gender on long-term responses to tiotropium in patients enrolled in UPLIFT.

During the 4 years of the study, there were no significant differences between men and women in the rate of decline in FEV₁.

The hazard ratio (HR) for a hospitalised exacerbation was 0.89 and 0.77, respectively. The HR for mortality during treatment was 0.85 for men and 0.85 for women. Improvements in SGRQ total score (tiotropium-placebo) at 1, 2, 3, and 4 years were -2.8, -2.3, -3.6, and -2.4 for men and -2.7, -2.6, -2.6, and -2.1 for women (P < .05 for all values).

According to Dr. Tashkin, tiotropium is effective over the long-term in men and women.

Funding for this study was provided by Boehringer-Ingelheim and Pfizer.

[Presentation title: Efficacy of Tiotropium in Men and Women: 4-Year Follow-Up in the UPLIFT Trial]

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