Chest
Clinical Investigations: COPDExtended Therapy With Ipratropium Is Associated With Improved Lung Function in Patients With COPD: A Retrospective Analysis of Data From Seven Clinical Trials
Section snippets
Data Reviewed
The data presented in this report include all the clinical trial efficacy data comparing ipratropium with a β-agonist in long-term (90-day) trials. Previous publications based on these studies have addressed the effectiveness of ipratropium as a short-term acute bronchodilator14,15 but have not specifically addressed the effects of extended therapy. The data are derived from the following four drug development programs conducted by Boehringer Ingelheim Pharmaceuticals, Ridgefield, Conn, from
Evaluable Patients
Seven 90-day studies in patients with COPD were conducted with ipratropium. In three studies, medications were administered via nebulizer; in four, medications were administered via metered-dose inhaler. The seven studies included 1,836 patients, 909 of whom were randomized to receive β-agonist and 927 of whom were randomized to receive ipratropium. Seven hundred one of the β-agonist group (77%) and 744 of the ipratropium group (80%) completed the 90 days of study and were available for
DISCUSSION
The current study assessed the effects of 90-day administration of ipratropium compared to β-agonist in patients with COPD. Over the 90-day period, improvements in baseline lung function, as assessed by both FEV1 and FVC, were observed in ipratropium-treated patients. Ipratropium is also an acute bronchodilator, and the lung function achieved after acute bronchodilator was also greater at the end of the treatment period. These effects contrasted with the patients who were treated with
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2011, Pulmonary Pharmacology and TherapeuticsCitation Excerpt :However, the general lack of significance and variable findings in other previous studies and the inconsistency in the results of the current study suggest that few conclusions can be made regarding the differences between smokers and ex-smokers. Two of the previously mentioned studies, the UPLIFT study and the meta-analysis of data from ipratropium trials, also investigated improvement in FEV1 based on disease severity [14,23]. In the UPLIFT trial, those with lower baseline lung function generally showed greater acute responses at baseline to combination short-acting bronchodilator therapy compared with those with higher baseline values [14].
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