Tiotropium reduced exacerbations and health resource use in COPD: COMMENTARY

Mahler, Donald A.
November 2003
ACP Journal Club;Nov/Dec2003, Vol. 139 Issue 3, p64
Academic Journal
Researchers V. Brusasco and colleagues have focused on three outcomes exacerbations, health-related quality of life (HRQL) and dyspnea of the four important clinical outcomes in evaluating pharmacotherapy for chronic obstructive pulmonary disease (COPD). The requirement to stop inhaled anticholinergic therapy and long-acting β-agonists before enrollment probably contributed to withdrawals and shows the challenges of long-term trials in symptomatic and impaired patients. The delayed time to first exacerbation and the fewer number of COPD exacerbations observed with tiotropium can be expected to have a major effect on reducing hospitalizations and overall health care costs. Although both tiotropium and salmeterol improved HRQL and dyspnea, neither agent achieved the minimal important difference established for the SGRQ compared with placebo. Compared with placebo, salmeterol was efficacious in some randomized controlled trials, but this and other trials failed to show a consistent benefit.


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