Spiriva Safe, Effective for COPD Patients

However, treatment does not slow disease progression, researchers say

By Steven Reinberg
HealthDay Reporter

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SUNDAY, Oct. 5 (HealthDay News) -- For patients suffering from chronic obstructive pulmonary disease (COPD), tiotropium (Spiriva) improves lung function and quality of life but does not significantly slow progression of the disease, a new study finds.

Spiriva and a similar drug, Atrovent, are the most commonly prescribed once-daily treatments for COPD, a respiratory illness that's the fourth largest killer in the United States. Recently, studies have associated these medications with a 58 percent increased risk of heart attack, stroke and other cardiovascular problems.

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"We found that patient-centered outcomes such as health-related quality of life, exacerbations, and even mortality were better in the treated versus the control group," said study co-author Dr. Bartolome R. Celli, chief of pulmonary care at St. Elizabeth's Medical Center in Boston. "In addition, there were no increased numbers of cardiovascular events or stroke in treated versus controls."

This is the longest multi-center trial evaluating the effect of a long-acting bronchodilator compared with usual care in COPD patients, Celli said. Tiotropium is in a class of drugs called anticholinergic bronchodilators, which prevent the airway spasms that can make breathing difficult.

"Patients with COPD respond to therapy," Celli said. "The rate of decline of lung function is similar between patients treated with tiotropium and patients treated with usual long-acting medications, and tiotropium is safe," he added.

The report was published in the Oct. 5 online edition of the New England Journal of Medicine and coincided with a presentation of the study at the European Respiratory Society's Annual Congress, in Berlin.

For the study, Celli and his colleagues randomly assigned 5,993 COPD patients to treatment with tiotropium or placebo. In addition, patients were allowed to take all of their other respiratory medicines, except for other inhaled anticholinergic bronchodilators.

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