Earlier COPD therapy 'can slow disease progression'

Study shows risk of hospital admission reduced by a quarter.

Photograph: GCA/SPL
Photograph: GCA/SPL

Starting COPD treatment at an earlier stage could help reduce lung function decline, an international study has found.

Previous research has failed to show clear benefits of initiating drug therapy for patients with early-stage COPD.

For this study, researchers investigated 2,376 patients who were enrolled in the UPLIFT study and had moderate COPD, defined as 'stageII' by the Global Initiative for Chronic Obstructive Lung Disease.

A total of 1,218 patients were randomised to receive tiotropium. The remaining 1,158 patients were given a placebo.

Patients had their COPD symptoms monitored every three months until the end of the four-year study period.

Rate of decline of mean post-bronchodilator FEV1 per year was 12 per cent lower among patients treated with tiotropium compared with placebo.

The risk of exacerbations was reduced by 18 per cent and the risk of being admitted to hospital for COPD fell by 26 per cent for the tiotropium group.

Patients taking tiotropium had a better health status, measured by questionnaires, throughout the study period.

Dr David Halpin from the Royal Devon and Exeter Hospital, UPLIFT's principal UK investigator, said: 'Many patients with early disease live with their symptoms because they do not realise anything can be done to help them. This study shows that the right treatment at early stages of the disease can make a difference and slow its progression.'

Peter Calverley, professor of respiratory medicine at the University of Liverpool and a member of the programme board for the DoH's COPD National Service Framework, said that the data showed treating patients earlier than currently recommended is effective and beneficial.

He added that the findings were in line with DoH plans for early identification of COPD.

- The Lancet Online 2009.

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