A landmark COPD trial published in the New England Journal of Medicine demonstrates that tiotropium improves survival and sustains lung function improvements over four years.
The results of the UPLIFT trial, presented at the European Respiratory Society (ERS) Annual Congress, confirmed that tiotropium administered to patients with chronic obstructive pulmonary disease (COPD) demonstrated significant improvements in lung function over 4 years compared with the control group. The rate of decline in lung function, the primary endpoint, was not altered.
UPLIFT, one of the largest COPD trials ever undertaken, involved 5,993 COPD patients from 37 countries globally, compared tiotropium 18ug once daily with placebo (control).
UPLIFT also demonstrated that patients treated with tiotropium experienced a significant delay in time to first exacerbation by an average of 4.1 months, as well as a significant reduction in the number of exacerbations per patient year. Additionally, tiotropium reduced the risk of exacerbations leading to hospitalisations by 14% compared with the control group.
Reducing exacerbations can improve patients' health status and quality of life, as well as help to reduce the huge cost that is associated with their management - the National Institute for Health and Clinical Excellence (NICE) estimates that the direct cost of COPD to the NHS is more than £491m per year. More than half of the direct costs relate to care in hospital.
"Sustained lung function improvement and positively impacting patient-centred outcomes are important but challenging therapeutic goals in COPD." said principal investigator Dr David Halpin. "The positive results from the UPLIFT trial which had a high proportion of mild COPD patients, suggest that tiotropium may have multiple long-term benefits even when used in patients with mild disease and overall the effects are similar to turning the clock back at least 4 years. These effects are seen over and above the effects of other drugs and the safety data are very reassuring."
The data also demonstrated a convincing argument in favour of early treatment, due to the large number of COPD patients classed by NICE as "mild" who sustained significant improvements in lung function over the four year duration.
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