Formoterol and Tiotropium Compared With Tiotropium Alone for Treatment of COPD

Abstract

Combined use of β₂-agonists and anticholinergic bronchodilators may have complementary benefits in patients with chronic obstructive pulmonary disease (COPD). The objective of this study was to compare combination treatment with formoterol (FORM) plus tiotropium (TIO) versus treatment with TIO alone in patients with COPD. In this active-controlled, double-blind, multicenter trial, a total of 255 subjects with diagnosed COPD were randomized to 12 weeks of either a combination of FORM 12 μ g twice-daily plus TIO 18 μ g once-daily in the morning (QD AM) or monotherapy with TIO 18 μ g QD AM. The primary efficacy variable was the area under the curve for forced expiratory volume in 1 second measured 0 to 4 hours after AM dosing (FEV₁ AUC_0−4h). Significantly greater improvements in the FEV₁ AUC_0−4h were seen with FORM + TIO (n = 116) versus TIO (n = 124) at all time points. The increase in FEV₁ 5 minutes after the first dose was 180 mL with FORM + TIO versus 40 mL with TIO (p < 0.001). At endpoint, FEV₁ AUC_0−4h increased 340 mL with FORM + TIO versus 170 mL with TIO (p < 0.001). Improvements in trough FEV₁ with FORM + TIO versus TIO were 180 mL and 100 mL, respectively (p < 0.01). Significantly greater reductions from baseline in symptom scores (p < 0.05) and daytime albuterol use (p < 0.04) were seen at endpoint with combination FORM + TIO versus TIO monotherapy. Both treatments were well tolerated. This study demonstrated that concurrent treatment with FORM + TIO results in greater therapeutic benefits than TIO alone.

Key words: :

• COPD
• formoterol
• tiotropium
• area under the curve