Re-evaluation of the uplift clinical trial, using age-appropriate spirometric criteria.

RE-EVALUATION OF THE UPLIFT CLINICAL TRIAL, USING AGE-APPROPRIATE SPIROMETRIC CRITERIA. Chest. 2020 Apr 09;: Authors: Vaz Fragoso CA, Leo-Summers LS, Gill TM, McAvay GJ Abstract BACKGROUND: The clinical trial of tiotropium in chronic obstructive pulmonary disease (COPD), i.e. UPLIFT, enrolled adults with a mean age of 65 years and moderate-to-severe airflow-obstruction, based on criteria from the Global Initiative for Chronic Obstructive Lung Disease (GOLD). For the UPLIFT cohort, however, GOLD-based criteria are not age-appropriate. RESEARCH QUESTION: Will the use of more age-appropriate criteria for airflow-obstruction from the Global Lung Function Initiative (GLI) modify the spirometric classification of the UPLIFT cohort and, in turn, the mortality effect of tiotropium in COPD? STUDY DESIGN: and Methods: Baseline spirometric classifications were first cross-tabulated by GLI- and GOLD-based criteria. Next, in GLI- and GOLD-based airflow-obstruction, modified intention-to-treat analyses evaluated differences in time-to-death over 4 years, comparing tiotropium vs. placebo. Since treatment response may differ by COPD severity, the mortality effect was also evaluated within stratum defined by GLI- and GOLD-based moderate and severe airflow-obstruction. RESULTS: Of 5898 participants with GOLD-based airflow-obstruction, staged as moderate in 2739 (46.4%) and severe in 3156 (53.5%), GLI-based criteria established ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research