Document Detail

Tiotropium for the treatment of stable chronic obstructive pulmonary disease: a systematic review with meta-analysis.
MedLine Citation:
PMID:  16621638     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Current guidelines recommend the use of inhaled tiotropium in patients with stable chronic obstructive pulmonary disease (COPD). However, this statement is based on a relatively small number of randomized controlled trials (RCTs) and related systematic reviews. This review was undertaken to incorporate the more recent evidence available about the effectiveness of tiotropium bromide compared with placebo, iptratropium bromide or long-acting beta-agonists (LABAs), for the treatment of stable COPD patients. DATA SOURCE: Medline, EMBASE, CINAHL, and the Cochrane Controlled Trials Register (to February 2006) were searched to identify all published RCTs. We also searched bibliographies of relevant articles. RESULTS: Data from 13 RCT (6078 subjects, 80% male) showed that tiotropium reduced COPD-related exacerbations (OR=0.76; 95% CI: 0.68-0.87) and hospital admissions (OR=0.59; 95% CI: 0.47-0.73) compared with placebo. Also, tiotropium showed statistically significant improvement in lung function, including trough, average, and peak FEV(1) and FVC from baseline, compared with placebo and ipratropium. The administration of inhaled tiotropium lead to 30% reduction in COPD-related admissions (OR= 0.67; 95% CI: 0.46-0.98) compared with LABAs. Finally, increases in FEV(1) and FVC from baseline were significantly larger with tiotropium than with LABAs. CONCLUSIONS: This review clearly supports the beneficial effects of the use of tiotropium in stable moderate-to-severe COPD patients, and increases the evidence in favor of the superiority of tiotropium on LABAs.
Gustavo J Rodrigo; Luís J Nannini
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review     Date:  2006-03-02
Journal Detail:
Title:  Pulmonary pharmacology & therapeutics     Volume:  20     ISSN:  1094-5539     ISO Abbreviation:  Pulm Pharmacol Ther     Publication Date:  2007  
Date Detail:
Created Date:  2007-07-24     Completed Date:  2007-12-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715279     Medline TA:  Pulm Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  495-502     Citation Subset:  IM    
Clínica Respirar, Benito Nardone 2310, Montevideo 11300, Uruguay.
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MeSH Terms
Adrenergic beta-Agonists / therapeutic use
Bronchodilator Agents / therapeutic use*
Forced Expiratory Volume
Ipratropium / therapeutic use
Pulmonary Disease, Chronic Obstructive / drug therapy*
Randomized Controlled Trials as Topic
Scopolamine Derivatives / therapeutic use*
Vital Capacity
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Bronchodilator Agents; 0/Scopolamine Derivatives; 136310-93-5/tiotropium; 60205-81-4/Ipratropium

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