Long-acting anticholinergic improves lung function for a range of COPD patients
Treatment with the long-acting anticholinergic tiotropium (Spiriva) improves lung function and reduces exacerbations in patients with chronic obstructive pulmonary disease, according to the first primary care study to investigate this in a broad range of patients.
The SPRUCE (Spiriva usual care) study randomised 395 patients with COPD
from 48 practices across the UK to inhaled tiotropium (18µg once
daily) or placebo. The average age of the patients was 65 years and just
over half (54 per cent) were male. On average, lung function was 54 per
cent of that predicted, with the group including patients with mild and
moderate COPD.
Nearly two-thirds (63 per cent) of the patients continued their treatment
with inhaled corticosteroids and one in three (29 per cent) were on long-acting
beta2 agonists.
Results reported at this week’s American
Thoracic Society meeting
in San Diego, showed improvements in lung function with tiotropium. Trough
FEV1 (forced expiratory volume in one second, 24 hours after dosing)
increased by 0.09L at 12 weeks, compared with an increase of 0.03L in
the placebo group (P=0.0102) and forced vital capacity also increased
(0.09L vs 0.01L; P=0.0002).
Approximately half as many patients treated with tiotropium experienced
COPD exacerbations as those treated with placebo (9.5 per cent vs 17.9
per cent; P<0.05).
Lead author of the study, David Price, professor of primary care respiratory
medicine, University of Aberdeen, said: “Our study was the first
to show that [tiotropium] is effective in patients typical of normal
clinical practice in primary care, with similar efficacy across a broad
range of COPD severity and in patients already taking a wide variety
of other treatments, including inhaled corticosteroids and long-acting
beta2 agonists.” |
The
Pharmaceutical Journal
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