The combination of ipratropium and albuterol optimizes pulmonary function reversibility testing in patients with COPD

Study objectives: To determine whether the combination of ipratropium bromi de and albuterol results in greater and more consistent pulmonary function test (PFT) response rates than ipratropium bromide or albuterol alone in pa tients with COPD, Design: Retrospective review of tyro recently completed 3-month, randomized , double-blind, parallel, multicenter; phase III trials, Setting: Outpatient, Patients: A total of 1,067 stable patients with COPD, Interventions: Ipratropium bromide (36 mu g qid), albuterol base (180 mu g qid), or an equivalent combination of ipratropium bromide and albuterol sul fate (42 mu g and 240 mu g 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, Regardl ess of whether a 12% or a 15% increase in FEV1 was used to define a positiv e response, an equivalent combination of ipratropium bromide and albuterol sulfate was superior to the individual agents (p < 0.05; all comparisons wi thin 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 sulf ate during the initial PFT and continued to be observed 3 months after init ial testing, Conclusions: Use of a combination of ipratropium bromide and albuterol sulf ate is superior to the individual agents in identifying PFT reversibility i n patients with COPD.