Tiotropium in COPD: Long-Term Effects

Tiotropium led to symptomatic and spirometric improvements in lung function but did not attenuate FEV₁ decline.

In patients with chronic obstructive pulmonary disease, no intervention except smoking cessation has been proven to slow the inevitable decline in FEV₁. In this manufacturer-sponsored international trial, researchers examined whether the long-acting inhaled anticholinergic drug tiotropium (Spiriva) blunts FEV₁ decline in patients with moderate-to-severe COPD. Nearly 6000 patients were randomized to receive tiotropium or placebo; only about 60% completed the 4-year trial (40% is a typical dropout rate for COPD trials).

Because of tiotropium’s reversible effect on bronchoconstriction, tiotropium recipients had consistently higher mean FEV₁ values than did placebo recipients throughout the trial (by about 100 mL before administration of short-a…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose