2012 OPEN FORUM Abstracts
POOLED DATA ANALYSIS OF THE IMPACT OF TIOTROPIUM HANDIHALER ON THE MORTALITY OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
Alexandros G. Mathioudakis1, Prodromos Kanavidis2, Victoria Chatzimavridou-Grigoriadou2, Ioannis Gialmanidis2, Stavroula G. Amanetopoulou2, Efstathia I. Evangelopoulou2, Georgios A. Mathioudakis2; 1Medical Department, Macclesfield District General Hospital, Macclesfield, United Kingdom; 2Respiratory Department, General Hospital of Nikaia St. Panteleimon, Piraeus, Greece
Objectives: Medical therapy of Chronic Obstructive Pulmonary Disease (COPD) currently aims to reduce the exacerbation rates and to improve the quality of life. Only longterm oxygen administration has been proved to prolong the survival of COPD. The purpose of this meta-analysis was to synthesize current evidence regarding the impact of tiotropium handihaler on the survival rate of these patients, which is still controversial. Methods: A systematic search in the electronic databases of the Cochrane Library, Medline and Scopus was conducted by two independent authors (May 2012). Randomised Controlled Trials (RCTs) and Cohort studies comparing inhaled tiotropium versus control (placebo or open control) or prescriptions with versus without inhaled tiotropium in the treatment of patients with stable COPD were included. Data on total mortality were extracted and missing data were obtained from authors. Relative risk (RR) for total mortality was calculated for each study and pooled. Data were non-heterogeneous, so fixed effects model analysis were used. Results: 27 Randomised Controlled Trials and two cohorts, evaluating 36754 patients, met the inclusion criteria. Inhaled tiotropium, when added to the prescriptions of COPD patients was associated with a decreased risk of all-cause mortality (relative risk 0.782, 95% confidence interval 0.715 to 0.854). The number needed to treat to prevent one fatality was estimated to be 65.53 (95% CI 51.44-120.94). Conclusion: Statistically significant reduction of the mortality rate was found in patients who were prescribed tiotropium in the maintenance treatment of COPD. Further studies are needed to determine the impact of tiotropium on different stages of COPD and on the cause-specific mortality. Sponsored Research - None