Impact of tiotropium on the course of moderate-to-very severe chronic obstructive
pulmonary disease: the UPLIFT trial.
Author(s): Tashkin DP.
Affiliation(s): David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA
90272, USA. dtashkin@mednet.ucla.edu
Publication date & source: 2010, Expert Rev Respir Med. , 4(3):279-89
The Understanding Potential Long-term Improvements in Function with Tiotropium
(UPLIFT) trial was a global 4-year randomized placebo-controlled clinical trial
that evaluated the long-term impact of tiotropium bromide 18 microg once daily on
the accelerated age-related decline in pre- and post-bronchodilator forced
expiratory volume in 1 s (FEV(1); co-primary end points). Secondary end points
included lung function at serial clinic visits, health-related quality of life,
exacerbations, exacerbation-related hospitalizations, mortality, safety and
tolerability. The study was carried out in 5992 patients (75% male, mean age 65
years, 30% current smokers) with moderate-to-very severe chronic obstructive
pulmonary disease who were permitted to receive prescribed treatment with
long-acting beta(2)-agonists and/or inhaled corticosteroids in addition to the
study drug. While the results failed to show an effect of tiotropium on the
primary end points (rate of decline in pre- and post-bronchodilator FEV(1)), they
did show improvements in lung function and health-related quality of life that
were maintained throughout the study and a reduction in the risk of exacerbations
and related hospitalizations. Tiotropium also reduced all-cause mortality in
patients on treatment over the 4-year trial period and reduced lower respiratory
and cardiovascular morbidity, including respiratory failure and myocardial
infarction. Adverse events were consistent with the drug's known anticholinergic
pharmacology.
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