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Abstract
Objective
To determine the effect of changing anticholinergic therapy in patients with COPD from ipratropium to tiotropium on pulmonary function.
Methods
We examined records of patients prescribed high-dose ipratropium, who were subsequently converted to tiotropium. Spirometric values were obtained within 2 days of the change in medication and after 56 to 224 days of the switch to tiotropium.
Results
15 subjects were documented to have filled a prescription for ipratropium-containing medications the month prior to the change. Medication compliance over the 6 months prior to the switch in these patients was 72% ± 31% (mean ± SD) for ipratropium compared to 87% ± 14% for tiotropium over the 6-month period after the switch (P = 0.1). FEV1 improved from 1.12 ± 0.39 L at baseline to 1.37 ± 0.49 L after the change to tiotropium (P = 0.01). FVC also improved from 2.45 ± 0.73 L at baseline to 2.72 ± 0.69 L after the change (P = 0.04). Maximal voluntary ventilation was also increased from 39.67 ± 10.7 L/min to 45.13 ± 15.8 L/min (P = 0.045).
Conclusions
We conclude that replacing high-dose ipratropium with tiotropium therapy significantly improves pulmonary function in a clinical setting.
Disclosures
Dr Cooper has been on the speakers’ bureau for Boehringer Ingelheim, Pfizer and Glaxo Smith Kline pharmaceuticals in the past and has also performed clinical trials for each of this companies.
Dr Dransfield has been on the speakers’ bureau for Boehringer Ingelheim, Pf izer and Glaxo Smith Kline pharmaceuticals and has performed clinical trials for these companies.