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Eur Respir J. 2010 Jul;36(1):65-73. doi: 10.1183/09031936.00127809. Epub 2010 Feb 25.

Tiotropium as a first maintenance drug in COPD: secondary analysis of the UPLIFT trial.

Collaborators (500)

Schiavi E, Figueroa Casas JC, Rhodius E, Gene R, Saenz CB, Giugno E, Di Bartolo C, De Salvo MC, Abbate E, Lopez AM, Steinfort C, Peters M, Carroll P, Simpson G, Freiberg D, Fogarty P, Watts R, Wheatley J, Vetter N, Burghuber O, Hesse C, Flicker M, Kahler C, Bral G, Carron K, Coolen D, De Backer W, De Beukelaar T, Decramer M, Deman R, Dewispelaere B, Driesen P, Elinck W, Mentens Y, Vandeurzen K, Van Renterghem D, Van Zandweghe L, Verhaeghe W, Vincken W, Delaunois L, Duchatelet P, Noseda A, Nuttin G, Rodenstein D, Thibaut-Baudrez A, Vandermoten G, Wackenier-Genard P, Baldassarre S, Schlesser M, Menna Barreto SS, Correa JC, Correa da Silva LC, Fiss E, Chibante AM, Dias de Mattos WL, Fritscher CC, de Oliveira JA, Pizzichini E, Neves M, Cruz A, de Castro Pereira CA, Cukier A, Stirbulov R, Brito Jardim JR, Kalandrova K, Novakova M, Hartman P, Jensovsky V, Vacek J, Kasak V, Erban J, Kalina P, Chlumsky J, Musil J, Hojka I, Havlikova A, Mares J, Klenha K, Vondra V, Havlik M, Parakova Z, Vlcek J, Dvorakova J, Mazacova H, Velart D, Pospisil L, Zajicova O, Kolman P, Binkova I, Fratrik J, Lange P, Backer V, Dahl R, Harving H, Tønnesen P, Munch E, Rasmussen OB, Tougaard L, Egede F, Hansen NC, Høegholm A, Rasmussen FV, Jakobsen KS, Wessels J, Frandsen JL, Evald T, Hilskov J, Garsdal P, Nielsen C, Haahr S, Korsgaard J, Revsbeck PA, Hansen JG, Soerensen T, Arnved JR, Møller A, Enevoldsen H, Døssing M, Christensen P, Christensen KD, Frølund L, Venho K, Pietilainen M, Saarelainen P, Kotaniemi J, Mannisto J, Aubier M, Pigearias B, Malaquin F, Grunchec N, Bernabeu L, Carme B, Prud'homme A, Bonte F, Boz D, Meunier R, Rasolojaona MT, Apprill M, Fargeon R, Bernard P, Tirouvanziam F, Legendre M, Jasnot JY, Barczok M, Becker JC, Pilz M, Grimm-Sachs V, Jahn M, Kemmerich B, Vorderstrasse W, Klein G, Kroemer B, Lehnert J, Redlich R, Schmidtmann S, Schultz T, Weber HH, Siafakas N, Anagnostopoulou O, Toubis M, Gourgoulianis K, Sichletides L, Kakoura M, Christaki P, Lychros I, Spiropoulos K, Bousmoukilia S, Hui DS, Yu WC, Chan HS, Wong ML, Baliko Z, Bisits M, Boszormenyi G, Marton M, Fonay K, Gyori Z, Hajdu L, Lukacs J, Kovacs G, Magyar P, Nagy G, Namenyi M, Meszaros E, Peto L, Somfay A, Kiraly Z, Strausz J, Szalai Z, Szilasi M, Szima B, Sztancsik Z, Costello R, Burke C, Paggiaro PL, Mazzocchi P, Cattaneo C, Peccini F, Dottorini M, Tazza R, Pirina P, Ginesu F, Ortu R, Sugamiele M, Mastroberardino M, Anzalone G, Canonica GW, De Benedetto F, Falcone F, Greco P, Papi A, Ciaccia A, Vincenti R, Parentini G, Tubaldi A, De Rose V, Ferretti G, Gasparini S, Legnani D, Ligia GP, Padua V, Santelli G, Mazza F, Boccieri MG, Cogo R, Lopes Pegna A, Pistolesi M, Colorizio V, Zanon P, Nishimura M, Yamauchi K, Ogawa H, Hattori T, Ichinose M, Kimura K, Kaneko N, Seyama K, Fukuchi Y, Kubo K, Taniguchi H, Hirata K, Tohda Y, Aizawa H, Matsumoto S, Sakalauskas R, Bagdonas A, Nargela RV, Mahayiddin AA, Harun R, Liam CK, Ortiz Peregrina JR, Díaz Castanon JJ, Posadas Valay R, Sansores Martinez RH, Peregrina AD, van Noord J, Aalbers R, Creemers JP, Dalinghaus WH, Eland ME, Pannekoek BJ, Pasma HR, Rudolphus A, Sinninghe Damste HE, Evers WB, Gans SJ, Timmer H, Westbroek J, Black P, Epton M, Dahle R, Eivindson A, Asmervik J, Arve Lier P, Canizares-Fernandez L, Guzman-Banzon A, Aquino T, Sy-Naval S, Trinidad T, Gorecka D, Piotr Plusa T, Pisarczyk-Bogacka E, Gorski P, Kozielski J, Pierzchala W, Szczeklik A, Kuna P, Slominksi JM, Almeida J, Sá R, Barbara C, Pato R, Moita J, Cardoso J, Chuchalin AG, Ovtcharenko S, Nonikov V, Ilkovich M, Tsoi A, Wang YT, Lo C, Lim TK, Kristufek P, Chovan L, Rozborilova E, Salat D, Plutinsky J, Suskovic S, Kosnik M, Turel M, Rezar L, Ulcar-Kostic S, Ras GJ, Du Toit JJ, Herbst L, van der Linden M, Nel AM, Jansen JJ, Bester FC, Colyn HJ, Abdullah I, Aboobaker Abdullah I, Bateman E, Budo JL, Pardo JM, Miravitlles M, Izquierdo Alonso JL, Adan PV, Morera J, Ferrer J, Alvarez-Sala JL, Francés JF, Otero FF, Alvarez MJ, Hernando HV, Perez AM, Flix SH, Bendito AS, Gimeno RB, Montemayor T, Fernandez-Montes CV, Vazquez SN, Pena VS, Goday MR, Villar AB, Olivas RB, Candeira SR, Agustí A, Ancochea J, Trigo JM, Gonzalez-Moro JM, Brotons B, Merino J, Tordera MP, Ruiz FO, Encuentra AL, Batista JJ, Pinilla FJ, Aguero R, Russi E, Soler M, Tamm M, Braendli O, Pons M, Tschopp JM, Hess T, Kuo HP, Shiao GM, Pothirat C, Wongtim S, Kiatboonsri S, Dejsomritrutai W, Boonsawat W, Erk M, Tuncay E, Celikel T, Caglayan B, Tabak L, Coplu L, Ardic S, Ucar N, Mirici A, Kocabas A, Erginel S, Cimrin AH, Mansur A, Bucknall C, Griffiths P, Halpin D, Morgan M, Morice A, Anderson P, Plant P, Britton M, Harrison T, Crooks S, Shales D, Douglas G, Gravil J, Altose MD, Amgott T, Andrews CP, Cote C, Averill F, Bailey W, Bensch G, Bleecker ER, Koh D, Block M, Braman S, Brannen AL, Brazinsky SA, Bruya T, Callahan D, Celli B, Condemi JJ, Corser B, Osmanski J, Craig T, Degraff A, Doherty DE, Anderson M, Doner M, Donohue J, Eichenhorn M, Ettinger N, Govert J, Folz R, Lasky J, Kovitz K, Friedman M, Giessel G, Pomerantz R, Castillo G, Greenwald GI, Hanania N, Hautamaki RD, Henderson W 4th, Heyder A, Hyers T, Ilowite J, Janes M, Kahn R, Harder R, Kaiser H, Kanner RE, Kaye M, Kreitzer S, Lawlor D, Leech I, Levine B, Littner M, Jarmukli N, Liu J, Lorch DG, Mahler D, Make B, Mandel M, Mathur P, Meyer DH, Milam MG, Mohsenifar Z, Moriarty T, Otoshi J, Patel R, Pratt A, Prenner B, Rehm J, Repsher L, Ries A, Rock KB, Sharafkhaneh A, San Pedro G, Scanlon PD, Scheinberg P, Schelbar EJ, Schul J, Fine J, Segall N, Seibert A, Serfillipi GL, Spirn I, Sussman R, Tashkin D, Wachtel A, Westerman J, Wise RA, Zielinski R, ZuWallack R, Ferguson G, Gelb A, Kuschner W, Mahutte K, Martinez F, Plautz M, Rochester C, Schilero G, Tino G, Turino G, Keppel J.

Abstract

The aim of the present study was investigate the long-term effect of tiotropium as first maintenance respiratory medication in chronic obstructive pulmonary disease (COPD). A 4-yr, randomised, multicentre, double-blind, parallel-group, placebo-controlled trial (Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) was conducted. Analysis focused on the effect of tiotropium versus matching placebo in the 810 (13.5%) COPD patients not on other maintenance treatment (long-acting beta-agonists, inhaled corticosteroids, theophyllines or anticholinergics) at randomisation. Spirometry, health-related quality of life (St George's Respiratory Questionnaire (SGRQ) score), exacerbations of COPD and mortality were also analysed. 403 patients (mean+/-sd age 63+/-8 yrs, post-bronchodilator forced expiratory volume in 1 s (FEV(1)) 53+/-12% predicted) received tiotropium and 407 (64+/-8 yrs of age, post-bronchodilator FEV(1) 51+/-12% pred) received placebo. Post-bronchodilator FEV(1) decline was 42+/-4 mL.yr(-1) in the tiotropium group and 53+/-4 mL.yr(-1) in the placebo group (p = 0.026). At 48 months, the morning pre-dose FEV(1) was 134 mL higher in the tiotropium group compared to the placebo group (p<0.001). SGRQ total score declined more slowly in the tiotropium group (difference of 1.05+/-0.34 units.yr(-1); p = 0.002). This was particularly significant for the impact (difference of 1.08+/-0.37 units.yr(-1); p = 0.004) and activity (1.44+/-0.40 units.yr(-1); p<0.001) domains, but not for symptoms (0.26+/-0.50 units.yr(-1); p = 0.6). At 48 months, the difference in total score was 4.6 units (p<0.001) with tiotropium compared to placebo. In patients with COPD who are not on maintenance therapy, tiotropium is associated with significant benefits in disease progression.

PMID:
20185426
[PubMed - indexed for MEDLINE]
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