Tiotropium in Combination with Placebo, Salmeterol, or Fluticasone-Salmeterol for Treatment of Chronic Obstructive Pulmonary Disease: A Randomized Trial
Article submitted by HMHB at 07:46, Fri 23 Mar 2007
PMID:
Objective: To determine whether combining tiotropium with salmeterol or fluticasone–salmeterol improves clinical outcomes in adults with moderate to severe COPD compared with tiotropium alone
Limitations: More than 40% of patients who received tiotropium plus placebo and tiotropium plus salmeterol discontinued therapy prematurely, and many crossed over to treatment with open-label inhaled steroids or long-acting ß-agonists.
Conclusions: Addition of fluticasone–salmeterol to tiotropium therapy did not statistically influence rates of COPD exacerbation but did improve lung function, quality of life, and hospitalization rates in patients with moderate to severe COPD.
Limitations: More than 40% of patients who received tiotropium plus placebo and tiotropium plus salmeterol discontinued therapy prematurely, and many crossed over to treatment with open-label inhaled steroids or long-acting ß-agonists.
Conclusions: Addition of fluticasone–salmeterol to tiotropium therapy did not statistically influence rates of COPD exacerbation but did improve lung function, quality of life, and hospitalization rates in patients with moderate to severe COPD.
Conflict of Interests - none