Comparison of tiotropium bromide and combined ipratropium/salbutamol for the treatment of COPD: a UK General Practice Research Database 12-month follow-up study

Jane Griffin, Sally Lee, Maria Caiado, Steven Kesten, David Brendan Price

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13 Citations (Scopus)


AIMS: To compare the effectiveness of the long-acting anticholinergic, tiotropium with ipratropium/salbutamol in reducing the risk of exacerbations and COPD-related referrals in patients with COPD. METHODS: Data were obtained from the General Practice Research Database (GPRD). Propensity score matching was used to balance prognostic covariates between treatment groups. Incidence rate ratios and 95% confidence intervals during a 12-month follow-up period were estimated. RESULTS: 4193 patients (3385, tiotropium; 808, ipratropium/salbutamol) in the GPRD met the inclusion/exclusion criteria. Patients treated with tiotropium had more severe COPD than patients treated with ipratropium/salbutamol. Following propensity score matching, 1222 tiotropium-treated patients and 633 ipratropium/salbutamol-treated patients were included in the final analysis. Incidence rate ratios (95% confidence intervals) were 0.74 (0.64-0.85; p=0.0086) for exacerbations and 0.57 (0.46-0.70; p=0.004) for COPD-related referrals/hospitalisations. CONCLUSIONS: Tiotropium is associated with a reduced risk of exacerbations and COPD-related referrals and hospitalisation compared to combined ipratropium/salbutamol in patients with COPD.
Original languageEnglish
Pages (from-to)104-110
Number of pages7
JournalPrimary Care Respiratory Journal
Issue number2
Early online date2 Apr 2008
Publication statusPublished - 1 Jun 2008



  • Aged
  • Albuterol
  • Bronchodilator Agents
  • Databases, Factual
  • Family Practice
  • Female
  • Follow-Up Studies
  • Great Britain
  • Hospitalization
  • Humans
  • Ipratropium
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive
  • Referral and Consultation
  • Retrospective Studies
  • Scopolamine Derivatives
  • Treatment Outcome
  • COPD
  • General Practice Database
  • Hospitalisation
  • Ipratropium/Salbutamol
  • Tiotropium

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