Tiotropium vs. Long-Acting β-Agonists for Older Patients with COPD

Prior studies have found tiotropium (Spiriva) to be superior to salmeterol, an inhaled long-acting β-agonist (LABA), in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD; JW Gen Med Mar 31 2011). In a retrospective cohort study, Canadian researchers compared survival among patients (age, ≥66) with COPD who initially received LABAs or tiotropium.

More than 15,000 propensity-matched pairs were included (mean age, 77; mean follow-up, 3.2 years). At 5 years, 52% of patients initially placed on tiotropium remained on the agent, and 29% were also taking LABAs; 41% of patients initially placed on LABAs remained on the agent, and 33% were also taking tiotropium. Approximately 38% of patients died. All-cause mortality was 1…