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Enhanced persistence with tiotropium compared with other respiratory drugs in COPD.
Respir Med. 2007 Jul; 101(7):1398-405.RM

Abstract

BACKGROUND

Tiotropium is a once-daily inhaled anticholinergic maintenance treatment with demonstrated effectiveness in chronic obstructive pulmonary disease (COPD).

OBJECTIVE

To compare persistence of tiotropium-use with other inhaled respiratory drugs in COPD in current clinical practice.

METHODS

The PHARMO database includes, among others, drug-dispensing and hospital discharge records for 2> or = million subjects in the Netherlands. All probable COPD-patients were identified by new respiratory drug use (age >54 years) or COPD-hospitalisations. New users of tiotropium, ipratropium, long-acting beta-agonists (LABAs), or fixed combination of LABA and inhaled corticosteroids (LABA+ICS), in 1998-2003, were included in the study. Persistence was assessed quarterly during the first year of follow-up. Patients with a proportion of days covered (PDC) > or =80% were considered persistent. Persistence was analysed using generalised estimating equations model.

RESULTS

About 37% of new users of tiotropium continued treatment for 1 year, compared with 14% for ipratropium, 13% for LABA, and 17% for LABA+ICS. Multivariate analyses showed that tiotropium-users were 2-3 times more persistent with their therapy than patients using ipratropium (relative risk [RR]: 2.0; 95% confidence interval [CI]: 1.8-2.3), LABA (RR: 2.9; 95% CI: 2.4-3.6), or LABA+ICS (RR: 2.4; 95% CI: 2.1-2.8), respectively. Sub-analyses in patients with a prior hospitalisation for COPD showed that 1-year persistence rates were increased for all treatments (varying from 33% for patients using LABA+ICS to 61% for patients using tiotropium), while persistence with tiotropium was again 2-3 times higher compared with other treatments.

CONCLUSION

Persistence with tiotropium was higher compared to other inhaled respiratory drugs in COPD in clinical practice.

Authors+Show Affiliations

PHARMO Institute, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17368011

Citation

Breekveldt-Postma, Nancy S., et al. "Enhanced Persistence With Tiotropium Compared With Other Respiratory Drugs in COPD." Respiratory Medicine, vol. 101, no. 7, 2007, pp. 1398-405.
Breekveldt-Postma NS, Koerselman J, Erkens JA, et al. Enhanced persistence with tiotropium compared with other respiratory drugs in COPD. Respir Med. 2007;101(7):1398-405.
Breekveldt-Postma, N. S., Koerselman, J., Erkens, J. A., Lammers, J. W., & Herings, R. M. (2007). Enhanced persistence with tiotropium compared with other respiratory drugs in COPD. Respiratory Medicine, 101(7), 1398-405.
Breekveldt-Postma NS, et al. Enhanced Persistence With Tiotropium Compared With Other Respiratory Drugs in COPD. Respir Med. 2007;101(7):1398-405. PubMed PMID: 17368011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enhanced persistence with tiotropium compared with other respiratory drugs in COPD. AU - Breekveldt-Postma,Nancy S, AU - Koerselman,Jeroen, AU - Erkens,Joëlle A, AU - Lammers,Jan-Willem J, AU - Herings,Ron M C, Y1 - 2007/03/23/ PY - 2006/09/22/received PY - 2007/01/10/revised PY - 2007/01/31/accepted PY - 2007/3/21/pubmed PY - 2007/9/12/medline PY - 2007/3/21/entrez SP - 1398 EP - 405 JF - Respiratory medicine JO - Respir Med VL - 101 IS - 7 N2 - BACKGROUND: Tiotropium is a once-daily inhaled anticholinergic maintenance treatment with demonstrated effectiveness in chronic obstructive pulmonary disease (COPD). OBJECTIVE: To compare persistence of tiotropium-use with other inhaled respiratory drugs in COPD in current clinical practice. METHODS: The PHARMO database includes, among others, drug-dispensing and hospital discharge records for 2> or = million subjects in the Netherlands. All probable COPD-patients were identified by new respiratory drug use (age >54 years) or COPD-hospitalisations. New users of tiotropium, ipratropium, long-acting beta-agonists (LABAs), or fixed combination of LABA and inhaled corticosteroids (LABA+ICS), in 1998-2003, were included in the study. Persistence was assessed quarterly during the first year of follow-up. Patients with a proportion of days covered (PDC) > or =80% were considered persistent. Persistence was analysed using generalised estimating equations model. RESULTS: About 37% of new users of tiotropium continued treatment for 1 year, compared with 14% for ipratropium, 13% for LABA, and 17% for LABA+ICS. Multivariate analyses showed that tiotropium-users were 2-3 times more persistent with their therapy than patients using ipratropium (relative risk [RR]: 2.0; 95% confidence interval [CI]: 1.8-2.3), LABA (RR: 2.9; 95% CI: 2.4-3.6), or LABA+ICS (RR: 2.4; 95% CI: 2.1-2.8), respectively. Sub-analyses in patients with a prior hospitalisation for COPD showed that 1-year persistence rates were increased for all treatments (varying from 33% for patients using LABA+ICS to 61% for patients using tiotropium), while persistence with tiotropium was again 2-3 times higher compared with other treatments. CONCLUSION: Persistence with tiotropium was higher compared to other inhaled respiratory drugs in COPD in clinical practice. SN - 0954-6111 UR - https://www.unboundmedicine.com/medline/citation/17368011/Enhanced_persistence_with_tiotropium_compared_with_other_respiratory_drugs_in_COPD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(07)00052-2 DB - PRIME DP - Unbound Medicine ER -