Treatment Of Tiotropium Bromide In Mild To Moderate Stable Chronic Obstructive Pulmonary Disease:A Meta-analysis

Objective:To evaluate the lung function,acute exacerbation and safety of tiotropium bromide in patients with mild to moderate stable chronic obstructive pulmonary disease through meta-analysis.Methods:We electronically searched databases including Pub Med,Embase,Cochrane Library,CNKI,China Biology Medicine disc and Wanfang Medical Database to search for randomized controlled clinical trials of tiotropium bromide in the treatment of mild to moderate chronic obstructive pulmonary disease.We selected the documents according to inclusion and exclusion criteria.We extracted the basic information,then we used Rev Man5.3 software for meta-analysis after the quality evaluation and data extraction of the included documents.Results:A total of 11 studies involving 8379 patients were included.The results of meta-analysis showed that:（1）The tiotropium group was superior to the control group in improving the FEV₁[MD=0.13,95%CI（0.08,0.17）,P<0.00001]and FVC[MD=0.36,95%CI（0.17,0.56）,P<0.0003].（2）The incidence of acute exacerbation[RR=0.86,95%CI（0.78,0.96）,P<0.006]and acute exacerbation hospitalization[RR=0.77,95%CI（0.66,0.90）,P<0.001]in the tiotropium group were lower than that in the control group,（3）There was no significant difference in the incidence of adverse events between the tiotropium and the control group[RR=1.08,95%CI（0.98,1.20）,P=0.13].Conclusion:For patients with mild to moderate stable COPD,long-term standard inhalation therapy with tiotropium bromide can improve lung function,reduce the occurrence of acute exacerbation and the frequency of acute exacerbation hospitalization,and can not increase the incidence of adverse events.