Tiotropium in Combination with Placebo, Salmeterol, or Fluticasone–Salmeterol for Chronic Obstructive Pulmonary Disease: Possible Confounding Effect of Treatment Withdrawal?
Authors: Shawn D. Aaron
Journal: Annals of Internal Medicine (2007)

Letters18 December 2007Tiotropium in Combination with Placebo, Salmeterol, or Fluticasone–Salmeterol for Chronic Obstructive Pulmonary Disease: Possible Confounding Effect of Treatment Withdrawal?Shawn D. Aaron, MDShawn D. Aaron, MDFrom the Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-12-200712180-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Brown for his comments. He is correct that many patients randomly assigned into our clinical trial were already taking inhaled corticosteroids and/or LABAs at enrollment and that withdrawal effects may have played a role in influencing clinical outcomes. However, the objective of our trial was to determine whether combination treatment with tiotropium plus salmeterol or tiotropium plus fluticasone–salmeterol improved clinical outcomes in adults with moderate and severe chronic obstructive pulmonary disease. We did not intend to limit the trial only to patients who were inhaled corticosteroid–naive and LABA-naive, because this would have potentially limited the ... Author, Article, and Disclosure InformationAffiliations: From the Ottawa Health Research Institute, Ottawa, Ontario K1H 8L6, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTiotropium in Combination with Placebo, Salmeterol, or Fluticasone–Salmeterol for Treatment of Chronic Obstructive Pulmonary Disease Shawn D. Aaron , Katherine L. Vandemheen , Dean Fergusson , François Maltais , Jean Bourbeau , Roger Goldstein , Meyer Balter , Denis O'Donnell , Andrew McIvor , Sat Sharma , Graham Bishop , John Anthony , Robert Cowie , Stephen Field , Andrew Hirsch , Paul Hernandez , Robert Rivington , Jeremy Road , Victor Hoffstein , Richard Hodder , Darcy Marciniuk , David McCormack , George Fox , Gerard Cox , Henry B. Prins , Gordon Ford , Dominique Bleskie , Steve Doucette , Irvin Mayers , Kenneth Chapman , Noe Zamel , Mark FitzGerald , and Tiotropium in Combination with Placebo, Salmeterol, or Fluticasone–Salmeterol for Chronic Obstructive Pulmonary Disease: Possible Confounding Effect of Treatment Withdrawal? Samuel M. Brown Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease? Yuji Oba Metrics Cited ByA role of budesonide/formoterol fixed combination in the treatment of stable chronic obstructive pulmonary disease. A conclusion of the Expert Council of the Volga Federal district of RussiaCombined corticosteroid and long-acting beta 2 -agonist in one inhaler versus placebo for chronic obstructive pulmonary disease2. LABA, Combined LABA and ICSCurrent World LiteratureDrug therapy of stable chronic obstructive pulmonary disease 18 December 2007Volume 147, Issue 12Page: 882-883KeywordsBronchodilatorsChronic obstructive pulmonary diseaseClinical trialsConflicts of interest ePublished: 18 December 2007 Issue Published: 18 December 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...