Determinants of long-term persistence with tiotropium bromide for chronic obstructive pulmonary disease

Kyuto Tanaka, Nobufumi Kamiishi, Jun Miyata, Hiroki Kabata, Katsunori Masaki, Hiromi Ogura-Tomomatsu, Katsuyoshi Tomomatsu, Yusuke Suzuki, Koichi Fukunaga, Koichi Sayama, Tomoko Betsuyaku, Koichiro Asano

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Tiotropium bromide, a long-acting anticholinergic agent, improves pulmonary function and quality of life of patients suffering from chronic obstructive pulmonary disease (COPD). We retrospectively examined the factors that determine the long-term persistence with tiotropium bromide. Among 6,301 patients who underwent pulmonary function tests in our pulmonary clinic between 2006 and 2009, 644 met the following criteria: 1) age > 40 years, 2) ≥ 20 pack-years smoking history, and 3) forced expiratory volume in 1 sec/forced vital capacity ratio < 0.7. The clinical information, including the prescription of tiotropium, was obtained from the patients' records. Tiotropium was administered to 255 patients (40%), of whom 48 (19%) discontinued treatment within 1 year, and 65 (25%) discontinued treatment within the median observation period of 32 months. The drug was discontinued because of ineffectiveness in 35 patients (73%), and because of adverse drug effects in 13 patients (27%). Young age, current smoking, absence of respiratory symptoms alleviation, and less severe disease characterized by a) mild airflow limitation, b) mild to moderate emphysema, or c) no exacerbation of COPD during the 1st year of treatment were predictors of drug discontinuation.

Original languageEnglish
Pages (from-to)234-242
Number of pages9
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume12
Issue number3
DOIs
Publication statusPublished - 2015 May 4

Keywords

  • Anticholinergic therapy
  • Long-term therapy
  • Tachyphylaxis
  • Treatment effectiveness
  • Treatment tolerability

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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