# Efficacy and safety of tiotropium combined with budesonide/formoterol in treating elderly patients with chronic obstructive pulmonary disease

## TL;DR

This study found that combining tiotropium with budesonide/formoterol improves lung function in elderly COPD patients without causing more side effects.

## Contribution

The novel contribution is demonstrating the enhanced efficacy of a combination therapy in elderly COPD patients compared to monotherapy.

## Key findings

- Combined tiotropium and budesonide/formoterol significantly improved pulmonary function metrics like FEV1 and FVC in COPD patients.
- The combination treatment led to greater reductions in COPD Assessment Test scores and inflammatory markers like HMGB1 and hs CRP.
- No increase in adverse reactions was observed with the combination therapy compared to tiotropium alone.

## Abstract

This study aimed to assess the efficacy and safety of the combined tiotropium (TIO) and budesonide/formoterol (BUD/FORM) treatment in elderly patients with chronic obstructive pulmonary disease (COPD).

Medical records of elderly patients with COPD who received treatment at the Third Affiliated Hospital of Zhejiang University of TCM from May 2023 to August 2024 were retrospectively analyzed. Elderly patients with COPD receiving TIO+BUD/FORM combination treatment (TIO+BUD/FORM group) and patients receiving TIO treatment alone were matched for age in a 1:1 ratio. The primary outcome of interest was the baseline change in pulmonary function at the 12 weeks follow-up. The secondary outcome was the incidence of adverse reactions.

This study included 114 patients. Post-treatment levels of forced vital capacity (FVC), FEV1 as a percentage of the predicted value (FEV1%pred), forced expiratory volume in one second (FEV1), and six-minute walk test (6MWT) in both groups increased compared to the baseline and were significantly higher in the TIO+BUD/FORM group compared to the TIO group (P<0.05). The treatment led to a significant decrease in the COPD Assessment Test (CAT) and levels of high-mobility group box 1 (HMGB1), as well as high-sensitive C-reactive protein (hs CRP) in both groups. These indexes were considerably lower in the TIO+BUD/FORM group than in the TIO group (P<0.05). The two groups had no difference in the rate of adverse reactions (P>0.05).

Compared with TIO alone, TIO combined with BUD/FORM is more effective in improving pulmonary function in elderly patients with COPD without increasing adverse reactions.