Evaluation of withdrawal of maintenance tiotropium in COPD

Sandra G Adams, Antonio R Anzueto, Dick D. Briggs, Inge Leimer, Steven Kesten

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1415-1420
Number of pages6
JournalRespiratory Medicine
Volume103
Issue number10
DOIs
StatePublished - Oct 2009

Fingerprint

Chronic Obstructive Pulmonary Disease
Maintenance
Dyspnea
Peak Expiratory Flow Rate
Health Status
Placebos
Tiotropium Bromide
Chronic Disease
Therapeutics
Drug Therapy

Keywords

  • COPD
  • Peak expiratory flow rate
  • Spirometry
  • St. George's Respiratory Questionnaire
  • Tiotropium
  • Transition dyspnea index

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Evaluation of withdrawal of maintenance tiotropium in COPD. / Adams, Sandra G; Anzueto, Antonio R; Briggs, Dick D.; Leimer, Inge; Kesten, Steven.

In: Respiratory Medicine, Vol. 103, No. 10, 10.2009, p. 1415-1420.

Research output: Contribution to journalArticle

Adams, Sandra G ; Anzueto, Antonio R ; Briggs, Dick D. ; Leimer, Inge ; Kesten, Steven. / Evaluation of withdrawal of maintenance tiotropium in COPD. In: Respiratory Medicine. 2009 ; Vol. 103, No. 10. pp. 1415-1420.
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