Abstract: Objective To evaluate the effects of tiotropium bromide combined with salmeterol/fluticasone on lung function and St. George’s respiratory questionnaire (SGRQ) score in the elderly patients with stable chronic obstructive pulmonary disease (COPD), and to analyze the cost-effectiveness. Methods A total of 60 patients with stable COPD were randomly divided into the observation group(n=30) and the control group(n=30). The control group was treated with salmeterol/fluticasone and the observation group were treated with tiotropium bromide combined with salmeterol/fluticasone. After six months of treatment, the lung function, SGRQ score, number of acute exacerbations were compared between the two groups, and a cost-effectiveness analysis was performed for the two treatment options. Results After the intervention, the levels of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the observation group were higher than those in the control group, and the SGRQ score was lower than that in the control group (P<0.05). FEV1/ FVC showed no significant differences between two groups (P> 0.05). The cost-effectiveness analysis showed that the cost-effectiveness ratio (C/E) of the observation group was significantly better than that of the control group (P<0.05). Conclusions The regimen of tiotropium bromide combined with salmeterol/fluticasone for the treatment of stable COPD in the elderly patients can significantly improve the lung function and SGRQ score, reduce the number of acute exacerbations, which shows better cost-effectiveness.

Key words: chronic obstructive pulmonary disease, aged, tiotropium bromide, pharmaceutical economics