A 4-Year Trial of Tiotropium in Chronic Obstructive Pulmonary Disease

In this large, randomized trial, the investigators compared outcomes in patients with chronic obstructive pulmonary disease (COPD) treated with once-daily inhalation of tiotropium or placebo. There was no benefit of treatment on the rate of loss of lung function over time, although benefits were observed in some secondary end points. These investigators compared outcomes in patients with chronic obstructive pulmonary disease treated with once-daily inhalation of tiotropium or placebo. There was no benefit of treatment on the rate of loss of lung function over time, although benefits were observed in some secondary end points. Prospective studies testing effects on the progression of chronic obstructive pulmonary disease (COPD) through the evaluation of the slope of the forced expiratory volume in 1 second (FEV 1 ) have not shown that inhaled short-acting anticholinergic drugs, inhaled corticosteroids, or N -acetylcysteine alter this marker of disease progression. 1 – 7 To date, only smoking cessation has prospectively been shown to alter the rate of decline of FEV 1 in patients with COPD. 2 Tiotropium is a once-daily, inhaled anticholinergic drug that provides at least 24-hour improvements in airflow and hyperinflation in patients with COPD. 8 – 10 Clinical trials lasting 6 weeks to . . .