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

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Objective: 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). Methods: 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. Results: 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). Conclusions: 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. doi: https://doi.org/10.12669/pjms.41.7.11995 How to cite this: Sun F, Hu D, Liu W, Wang X, Liu X, Wulan T. Efficacy and safety of tiotropium combined with budesonide/formoterol in treating elderly patients with chronic obstructive pulmonary disease. Pak J Med Sci. 2025;41(7):2023-2029. doi: https://doi.org/10.12669/pjms.41.7.11995 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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