Tiotropium for Mild COPD

Long-acting bronchodilators are first-line therapy for patients with chronic obstructive pulmonary disease (COPD); numerous studies have shown that these drugs improve lung function, symptoms, and exacerbations in patients with moderate-to-severe disease. However as many as 80% of patients with COPD are stage 1 (forced expiratory volume in 1 second [FEV₁], ≥80% of predicted value) or stage 2 (FEV1, 50%–79% of predicted). Whether long-term bronchodilator therapy benefits these patients is unclear.

In an industry-funded study, 841 Chinese patients with stage 1 or 2 COPD were randomized to once-daily inhaled tiotropium or placebo. At baseline, mean postbronchodilator FEV₁ was 78% of predicted, and mean postbronchodilator FEV₁ to forced vital ca…