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Tiotropium in Patients with Bronchiectasis: A Prospective Cohort Study

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Abstract

Purpose

There are limited studies on the use of bronchodilators for the treatment of bronchiectasis. This study investigated the efficacy of tiotropium in patients with bronchiectasis and airflow limitation.

Methods

This study was a prospective cohort study, including 169 patients with bronchiectasis and airflow limitation from 2015 to 2019. The clinical outcomes observed in our study were the effect of tiotropium on the frequency of moderate exacerbations, the time to the first severe exacerbation, and the annual decline in FEV1.

Results

After 12 months, the annual decline in the FEV1 after bronchodilator use was 27.08 ml or 42.9 ml per year in the group with or without tiotropium, respectively. Treatment with tiotropium was associated with a decreased risk of moderate exacerbation of bronchiectasis (Adjusted RR 0.618 95% CI 0.493–0.774; P < 0.005). The time to the first severe acute exacerbation of bronchiectasis in the tiotropium group was longer than the non-tiotropium group (Adjusted HR 0.333 95% CI 0.219–0.506; P < 0.001).

Conclusion

In conclusion, prospective cohort study showed that tiotropium effectively ameliorated the annual decline in the FEV1, with a lower-risk rate of moderate exacerbations and prolonging the time to the first-time severe exacerbation in patients with bronchiectasis and airflow limitation.

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Abbreviations

COPD:

Chronic obstructive pulmonary disease

LABA:

Long-acting β2 agonist

LAMA:

Long-acting muscarinic antagonist

BMI:

Body Mass Index

FEV1:

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

RR:

Relative risk

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Author notes

  1. Zu-Liang Shi and Hong-Ying Zhang have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Respiratory Medicine, Dongcheng Branch of First Affiliated Hospital of Anhui Medical University (Feidong People’s Hospital), Yao Gang Road, Feidong, 231600, Anhui, People’s Republic of China

    Zu-Liang Shi & Hai-Bo Peng

  2. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, People’s Republic of China

    Hong-Ying Zhang & Zhong-Ming Zhu

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Contributions

Z-LS and Z-MZ designed the study and Z-LS and H-YZ performed data analyses and wrote the report. H-BP performed investigation and data collection. All authors contributed to the review and revision of the manuscript and have read and approved the final version.

Corresponding author

Correspondence to Zhong-Ming Zhu.

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No potential conflict of interest was reported by the author(s).

Ethical Approval

This prospective observational study was approved by the Ethics Committee in the Beijing Rehabilitation Hospital, Capital Medical University (No. fd2015-001).

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Shi, ZL., Zhang, HY., Peng, HB. et al. Tiotropium in Patients with Bronchiectasis: A Prospective Cohort Study. Lung 201, 9–15 (2023). https://doi.org/10.1007/s00408-023-00597-8

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  • DOI: https://doi.org/10.1007/s00408-023-00597-8

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