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- W1932779107 abstract "For patients with more severe COPD, guidelines advocate the use of more than one long-acting bronchodilator in addition to ICS.Tiotropium has been shown to reduce COPD exacerbations (COPD-E), however benefits when it is used in conjunction with LABA/ICS still have to be demonstrated.We assessed the effect of tiotropium in reducing COPD-E when combined with LABA/ICS. We performed a cohort study including subjects with COPD hospitalization and at least one prescription of LABA/ICS within 6 months post-discharge. We classified patients as with or without tiotropium on the basis of the index prescription date. We restricted the analysis to new users and followed them for 1 year in an intention-to-treat approach to measure COPD-E rates,either severe(hospitalization) and/or moderate(oral corticosteroids and antibiotics use). We compared the risk of first COPD-E between patients with or without tiotropium, using Cox proportional hazard models (HR,95%CI) adjusting for sex, age, residency, comorbidities, COPD severity, prior drug use. Patients treated with LABA/ICS were 5657, 31.8% received triple therapy. The overall COPD-E rate was 26.3%. Previous COPD hospitalization, respiratory failure, use of systemic corticosteroids or xanthines were associated with high probability of COPD-E. The adjusted HR in patients with tiotropium vs. patients without was 1.02(0.89-1.17). Similar HRs were seen when severe and moderate COPD-E were considered separately, 1.07(0.90-1.27) and 0.94(0.77-1.15) respectively. Use of tiotropium in combination with LABA/ICS was not significantly associated with a reduction in the risk of COPD-E vs. LABA/ICS alone." @default.
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- W1932779107 date "2013-09-01" @default.
- W1932779107 modified "2023-10-02" @default.
- W1932779107 title "Role of tiotropium in reducing exacerbations in COPD patients when added to long-acting β2-agonists (LABA) and inhaled corticosteroids (ICS): The OUTPUL study" @default.
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