Rate of FEV1decline by FEV1percent predicted in UPLIFT® and TIOSPIR®

Introduction: Studies suggest that in patients with chronic obstructive pulmonary disease, the rate of decline in FEV 1 accelerates with increasing age. Factors influencing the rate of decline are poorly understood. Aims and objectives: To evaluate the relationship between mean annual rate of FEV 1 decline and baseline FEV 1 % predicted in patients from the Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT ® ) and TIOtropium Safety and Performance In Respimat ® (TIOSPIR ® ) trials. Methods: Annual rate of trough FEV 1 decline was calculated for patients on treatment >2 years, stratified by disease severity (baseline FEV 1 % predicted). Treatment arms were pooled. Results: Overall, decline was calculated for 4295 patients from UPLIFT ® receiving either tiotropium or placebo. Demographics did not differ by baseline severity, although GOLD Stage 4 patients (baseline FEV 1 % predicted 1 decline was greater in patients with higher baseline FEV 1 % predicted and less in patients with more severe disease (Figure). A similar pattern was observed in patients from TIOSPIR ® . Conclusions: In UPLIFT ® and TIOSPIR ® , the annual rate of decline in FEV 1 is almost linearly correlated to the initial disease status (baseline FEV 1 % predicted) and probably less dependent on age.