Comparison of tiotropium bromide and combined ipratropium/salbutamol for the treatment of COPD: A UK General Practice Research Database 12-month follow-up study

Abstract

Aims: To compare the effectiveness of the long-acting anticholinergic, tiotropium with ipratropium/salbutamol in reducing the risk of exacerbations and COPD-related referrals in patients with COPD. Methods: Data were obtained from the General Practice Research Database (GPRD). Propensity score matching was used to balance prognostic covariates between treatment groups. Incidence rate ratios and 95% confidence intervals during a 12-month follow-up period were estimated. Results: 4193 patients (3385, tiotropium; 808, ipratropium/ salbutamol) in the GPRD met the inclusion/exclusion criteria. Patients treated with tiotropium had more severe COPD than patients treated with ipratropium/salbutamol. Following propensity score matching, 1222 tiotropium-treated patients and 633 ipratropium/salbutamol-treated patients were included in the final analysis. Incidence rate ratios (95% confidence intervals) were 0.74 (0.64-0.85; p=0.0086) for exacerbations and 0.57 (0.46-0.70; p=0.004) for COPD-related referrals/hospitalisations. Conclusions: Tiotropium is associated with a reduced risk of exacerbations and COPD-related referrals and hospitalisation compared to combined ipratropium/salbutamol in patients with COPD. © 2008 General Practice Airways Group. All rights reserved.