Study objectives: To determine whether the combination
of ipratropium bromide and albuterol results in greater and more
consistent pulmonary function test (PFT) response rates than
ipratropium bromide or albuterol alone in patients with COPD.
Design: Retrospective review of two recently completed
3-month, randomized, double-blind, parallel, multicenter, phase III
Patients: A total of 1,067 stable patients with COPD.
Interventions: Ipratropium bromide (36 μg qid), albuterol
base (180 μg qid), or an equivalent combination of ipratropium
bromide and albuterol sulfate (42 μg and 240 μg qid, respectively).
Measurements and results: PFT response rates were
analyzed using 12% and 15% increases in FEV1 compared
with baseline values and were measured in the various treatment groups
on days 1, 29, 57, and 85 in these trials. Regardless of whether a 12%
or a 15% increase in FEV1 was used to define a positive
response, an equivalent combination of ipratropium bromide and
albuterol sulfate was superior to the individual agents (p < 0.05;
all comparisons within 30 min). In addition, a 15% or more increase in
FEV1 was seen in > 80% of patients who received the
combination of ipratropium and albuterol sulfate during the initial PFT
and continued to be observed 3 months after initial testing.
Conclusions: Use of a combination of ipratropium bromide
and albuterol sulfate is superior to the individual agents in
identifying PFT reversibility in patients with COPD.
PFT = pulmonary function test