Efficacy of tiotropium in COPD patients from Asia: A subgroup analysis from the UPLIFT trial

Yoshinosuke Fukuchi, Lenora Fernandez, Han Pin Kuo, Aziah Mahayiddin, Bartolome Celli, Marc Decramer, Steven Kesten, Dacheng Liu, Donald Tashkin

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

Background and objective: Studies in respiratory diseases other than chronic obstructive pulmonary disease suggest potentially differing responses to medications among patients from different regions. We report a subgroup analysis of patients recruited to Asian centres from a previously reported 4-year COPD trial. Methods: Subgroup analysis from a randomized, double-blinded, placebo-controlled trial of tiotropium 18 μg daily in COPD. Primary end-point was rate of decline in FEV 1. Secondary end-points included spirometry at individual time points, health-related quality of life (St George's Respiratory Questionnaire), exacerbations and mortality. Results: Of 5992 patients, 362 were from Asian centres (100 from Japan). Mean age 66 years, 95% men, 13% current smokers, BMI: 21 kg/m 2; post-bronchodilator FEV 1: 44% predicted; St George's Respiratory Questionnaire total score: 44 units. No treatment effect was observed for rate of decline in FEV 1 although annual decline was less in Asian patients. Morning prebronchodilator FEV 1 and forced vital capacity improved in Asian patients (P < 0.05). Tiotropium reduced number of exacerbations (rate ratio (95% confidence interval (CI)): 0.73 (0.57-0.94)). Hazard ratios (95%CI) for exacerbations and hospitalized exacerbations (tiotropium/control) were 0.81 (0.62-1.05) and 0.85 (0.61-1.19), respectively. St George's Respiratory Questionnaire total score improvedby 1.5-6.1 units (P < 0.05 for months 18, 24, 30 and 36) with tiotropium. Fatal events occurred in 34 tiotropium (18.5%) and 42 control (23.6%) patients. Conclusions: In COPD patients from Asia, tiotropium improves lung function, improves health-related quality of life and reduces exacerbations over 4 years of treatment.

Original languageEnglish
Pages (from-to)825-835
Number of pages11
JournalRespirology
Volume16
Issue number5
DOIs
Publication statusPublished - Jul 1 2011
Externally publishedYes

Keywords

  • Asia
  • Chronic obstructive pulmonary disease
  • Quality of life
  • Spirometry
  • Tiotropium

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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