Tiotropium Respimat Inhaler and the Risk of Death in COPD

This large trial involving patients with chronic obstructive pulmonary disease examined the relative safety of tiotropium inhalation delivered by two different devices. No significant differences in mortality were noted between the two devices. Tiotropium (Spiriva, Boehringer Ingelheim), a long-acting inhaled anticholinergic bronchodilator, improves lung function, quality of life, and exercise endurance and reduces exacerbations in patients with chronic obstructive pulmonary disease (COPD). 1 – 4 Tiotropium is approved and marketed as a dry-powder formulation delivered by means of the HandiHaler inhalation device (at a dose of 18 μg) 5 and as an aqueous solution delivered by means of the Respimat inhaler (at a dose of 5 μg) in many countries. 6 Crossover trials of tiotropium Respimat at a dose of 5 μg and HandiHaler at a dose of 18 μg for up to 4 weeks have shown . . .