TY - JOUR
T1 - Evaluation of withdrawal of maintenance tiotropium in COPD
AU - Adams, Sandra G.
AU - Anzueto, Antonio
AU - Briggs, Dick D.
AU - Leimer, Inge
AU - Kesten, Steven
N1 - Funding Information:
Sandra G. Adams: Support for Research Grants and/or honoraria for speaking: National Institute of Health (NIH), Veterans Affairs Cooperative Studies Program, ABComm Inc; Altana; AstraZeneca Pharmaceuticals LP; Aventis Pharmaceuticals, Inc; Bayer Pharmaceuticals Corp; Boehringer Ingelheim Pharmaceuticals, Inc; Centocor Inc, GlaxoSmithKline; Novartis Pharmaceuticals AG; Pfizer Inc; Schering-Plough Corp.
PY - 2009/10
Y1 - 2009/10
N2 - Introduction: In chronic diseases such as chronic obstructive pulmonary disease (COPD), patients may not perceive all of the benefits of drug therapy until withdrawal. Thus, we evaluated the effect of tiotropium withdrawal on clinical variables. Methods: COPD subjects who participated in two identical 1-year, prospective, double-blind, placebo-controlled studies of tiotropium 18 μg once daily who completed a 3-week visit following discontinuation of therapy were included in this analysis. Outcomes measured included dyspnea (transition dyspnea index [TDI]), Peak Expiratory Flow Rate (PEFR), health status (St George's Respiratory Questionnaire [SGRQ]), and rescue β2-agonist use. Results: Overall, the tiotropium group exhibited significant improvements in clinical parameters at the end of therapy. Of the entire cohort of 921 patients, 713 patients (77%) completed 3-weeks post-withdrawal evaluation. Patients in the tiotropium group had 1.1 unit worsening in TDI, decreased in PEFR, health status and reduced β2-agonist medication following treatment discontinuation, while the placebo group remained relatively stable. Conclusions: The withdrawal of tiotropium results in worsening of COPD over a three-week interval. There was no evidence of a rebound effect in response to tiotropium withdrawal.
AB - Introduction: In chronic diseases such as chronic obstructive pulmonary disease (COPD), patients may not perceive all of the benefits of drug therapy until withdrawal. Thus, we evaluated the effect of tiotropium withdrawal on clinical variables. Methods: COPD subjects who participated in two identical 1-year, prospective, double-blind, placebo-controlled studies of tiotropium 18 μg once daily who completed a 3-week visit following discontinuation of therapy were included in this analysis. Outcomes measured included dyspnea (transition dyspnea index [TDI]), Peak Expiratory Flow Rate (PEFR), health status (St George's Respiratory Questionnaire [SGRQ]), and rescue β2-agonist use. Results: Overall, the tiotropium group exhibited significant improvements in clinical parameters at the end of therapy. Of the entire cohort of 921 patients, 713 patients (77%) completed 3-weeks post-withdrawal evaluation. Patients in the tiotropium group had 1.1 unit worsening in TDI, decreased in PEFR, health status and reduced β2-agonist medication following treatment discontinuation, while the placebo group remained relatively stable. Conclusions: The withdrawal of tiotropium results in worsening of COPD over a three-week interval. There was no evidence of a rebound effect in response to tiotropium withdrawal.
KW - COPD
KW - Peak expiratory flow rate
KW - Spirometry
KW - St. George's Respiratory Questionnaire
KW - Tiotropium
KW - Transition dyspnea index
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U2 - 10.1016/j.rmed.2009.05.018
DO - 10.1016/j.rmed.2009.05.018
M3 - Article
C2 - 19523796
AN - SCOPUS:69249215521
SN - 0954-6111
VL - 103
SP - 1415
EP - 1420
JO - Respiratory Medicine
JF - Respiratory Medicine
IS - 10
ER -