Evidence map›Paper›PMID 26971242›Full record

Trial reportRespiratory research2016

Effect of tiotropium on night-time awakening and daily rescue medication use in patients with COPD.

Peter M A Calverley, Stephen I Rennard, Emmanuelle Clerisme-Beaty, Norbert Metzdorf, Valentina Bayer Zubek, Richard ZuWallack

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Respiratory research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
  4. Day and Night Control of COPD and Role of Pharmacotherapy: A Review.International journal of chronic obstructive pulmonary disease · 2020
    Review
  5. Revefenacin: A Once-Daily, Long-Acting Bronchodilator For Nebulized Treatment Of COPD.International journal of chronic obstructive pulmonary disease · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 3 countries.

Peter M A CalverleyClinical Science Centre, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK. pmacal@liverpool.ac.uk.
Stephen I RennardUniversity of Nebraska Medical Center, Omaha, NE, USA.
Emmanuelle Clerisme-BeatyBoehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA.
Norbert MetzdorfBoehringer Ingelheim GmbH, Ingelheim, Germany.
Valentina Bayer ZubekBoehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA.
Richard ZuWallackSt Francis Hospital Medical Center, Hartford, CT, USA.
Boehringer Ingelheim (United States) · USAintree University Hospital · GBBoehringer Ingelheim (Germany) · DESt. Francis Hospital · USUniversity of Nebraska Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral small studies found night-time awakenings due to COPD symptoms were associated with decreased health status. In this study, night-time awakenings in patients with COPD were examined and effects of tiotropium therapy evaluated.

methodsThis study was a post hoc, exploratory, pooled analysis of twin, multicenter, double-blind, randomized, placebo-controlled, parallel-group trials. Patients with stable moderate-to-severe COPD were randomized to tiotropium HandiHaler® (n = 550) or placebo (n = 371) and followed for 13 weeks. During a 2-week, pre-treatment baseline period and for 13 weeks on treatment, self-reported night-time awakenings due to COPD symptoms, rescue medication (albuterol) use, and morning and evening peak expiratory flow rate (PEFR) were recorded daily. Nightly, COPD-related awakenings were scored: 0 = no awakenings; 1 = 1 awakening; 2 = 2-3 awakenings; or 3 = awake most of the night. Health-related quality-of-life (HRQoL) and energy-fatigue questionnaires were completed at baseline and during treatment.

resultsPatients were aged 65.2 ± 8.7 years (mean ± SD), with a mean pre-bronchodilator FEV1 of 36.1 ± 13.5 % predicted normal at baseline. Data for night-time awakenings and albuterol use were available for 543 (99 %) patients on tiotropium and 352 (95 %) on placebo. At baseline, 280 (51.5 %) patients on tiotropium and 179 (50.1 %) on placebo reported ≥1 COPD-related night-time awakening per week. Over the 13-weeks' treatment, tiotropium was associated with fewer night-time awakenings, with mean ± SE overall awakening scores per week of 0.356 ± 0.006 compared with 0.421 ± 0.007 for placebo (p < 0.001); means were significantly lower for tiotropium versus placebo in patients with baseline awakenings (p < 0.001), but not for those without baseline awakenings. COPD-related night-time awakenings were associated with increased nocturnal rescue medication use and lower HRQoL ratings in both treatment arms. Following start of treatment, tiotropium decreased patients' use of rescue medication compared with placebo, and morning and evening adjusted means for PEFR were higher for tiotropium compared with placebo.

conclusionsTiotropium is associated with decreased COPD-related night-time awakenings. Night-time awakenings are associated with increased nocturnal rescue medication use and may be a surrogate marker of symptom control in patients with COPD.

Indexed as

Administration, InhalationAgedAlbuterolBronchodilator AgentsDouble-Blind MethodDrug Administration ScheduleDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPlacebo EffectPulmonary Disease, Chronic ObstructiveSleep Wake DisordersTiotropium BromideTreatment OutcomeAlbuterolBronchodilator AgentsTiotropium BromideAlbuterolBronchodilationCOPDLong-acting anticholinergicNight-time awakeningPeak expiratory flow rateRescue medicationTiotropium

Identifiers

PMID26971242
PMCPMC4789269
OpenAlexW2293494873

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.