Addition of tiotropium (T) to a regular treatment with long-acting β-agonist+inhaled corticosteroid (LABA+ICS) in patients with severe to very-severe COPD under in-patient pulmonary rehabilitation program (PRP)

Source: Annual Congress 2009 - Pulmonary rehabilitation: extending the scope and benefit of rehabilitation for patients with chronic respiratory disease

Session: Pulmonary rehabilitation: extending the scope and benefit of rehabilitation for patients with chronic respiratory disease
Session type: Thematic Poster Session
Number: 526

Disease area: Airway diseases

Abstract

We have examined whether T enhances the effects of exercise training in patients with severe to very-severe COPD and hypoxemia at rest. We enrolled 22 patients that were randomised to T 18 mcg or placebo (P) inhalation capsules taken once daily. Both groups (n=11 patients) underwent an in-patient PRP and were under regular treatment with LABA+ICS twice daily. The in-patients PRP included the following: exercise and muscle training (upper and lower extremity endurance training, respiratory muscle training and stretch); mucus evacuation techniques; disease education; psycosocial intervention; instruction in the use of medication; and relaxation techniques. Each session were held 5 days per week (3h/day) for a total of 4 weeks. Compared to P, T had larger impact on pulmonary function (FEV1 +0.127L, FVC +0.112L, RV -0.544L after T, FEV1 +0.084L, FVC +0.039L, RV -0.036L after P). The addition of T allowed a longer distance walked in 6 min (82.3m vs. 67.7m after P) and reduced dyspnoea (Borg score) (-0.4 vs. +0.18 after P) when compared with baseline (pre PRP). The changes in SGRQ from baseline to the end of treatment were: total score -28.3U, activity -27.8U, impact -14.5U, and symptoms -33.4U in the P group; and total score -19.1U, activity-18.9U, impact -16.4U, and symptoms -33.8U in the T group. These results suggest that the addition of T to a regular treatment with LABA+ICS can influence lung function and 6-MWT, but has not real impact on health related quality of life in patients with severe to very-severe COPD undergoing in-patient PRP.

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Citations should be made in the following way:
G. Biscione, G. Crigna, L. Auciello, F. Pasqua, M. Cazzola (Velletri (Rome), Rome, Italy). Addition of tiotropium (T) to a regular treatment with long-acting β-agonist+inhaled corticosteroid (LABA+ICS) in patients with severe to very-severe COPD under in-patient pulmonary rehabilitation program (PRP). Eur Respir J 2009; 34: Suppl. 53, 526

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