Three More Topics That Drew Our Attention in 2011

Tiotropium for patients with chronic obstructive pulmonary disease, medical therapy for certain patients who might have undergone coronary artery bypass grafting, and efficacy of the herpes zoster vaccine are all on our radar in 2011.

Both inhaled salmeterol (a long-acting β-agonist) and inhaled tiotropium (a long-acting anticholinergic agent) are accepted treatments for patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). In a randomized trial, researchers compared tiotropium and salmeterol in 7400 COPD patients; clinical outcomes were modestly, but statistically significantly, better in the tiotropium group (JW Gen Med Mar 31 2011). Based on this trial, one could argue that tiotropium should become the first-line long-acting bronchodilator for COPD patients. A caveat remains, however: Conflicting data, some from nonrandomized observational studies, have suggested that inhaled anticholinergic agents can elevate cardiovascular risk or mortality …

Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose