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Tiotropium Trial Supports Earlier Treatment for COPD

Last Updated: August 28, 2009.

In patients with moderate chronic obstructive pulmonary disease, treatment with tiotropium may reduce the rate of decline in lung function and increase the time to exacerbations, suggesting that treatment should begin at an early stage of the disease, according to a study published online Aug. 28 to coincide with the Aug. 29 special issue of The Lancet focusing on COPD.

FRIDAY, Aug. 28 (HealthDay News) -- In patients with moderate chronic obstructive pulmonary disease (COPD), treatment with tiotropium may reduce the rate of decline in lung function and increase the time to exacerbations, suggesting that treatment should begin at an early stage of the disease, according to a study published online Aug. 28 to coincide with the Aug. 29 special issue of The Lancet focusing on COPD.

Marc Decramer, M.D., of the University of Leuven in Belgium, and colleagues from the Understanding Potential Long-Term Impacts on Function with Tiotropium (UPLIFT) study assessed 2,739 patients (mean age, 64 years) with GOLD stage II COPD who were randomly assigned to receive either tiotropium or placebo for four years.

Compared to controls, the researchers found that the tiotropium group had a lower rate of decline of mean post-bronchodilator forced expiratory volume in one second per year (43 mL versus 49 mL). They also found that the tiotropium group had a significantly longer time to first exacerbation and time to exacerbation resulting in hospital admission (hazard ratios, 0.82 and 0.74, respectively).

"Since we also found that lung function and health-related quality of life were better in the tiotropium group than in the control group throughout the trial, treatment of COPD should begin in symptomatic patients with moderate disease," the authors conclude.

The study was supported by Boehringer Ingelheim and Pfizer; several researchers reported financial relationships with these companies.

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