Inhaled Long-Acting β-Agonists Versus Anticholinergics in Older Patients With Chronic Obstructive Pulmonary Disease
Authors: Leonardo M. Fabbri, Claus Vogelmeier, Klaus F. Rabe
Journal: Annals of Internal Medicine (2011)

Letters18 October 2011Inhaled Long-Acting β-Agonists Versus Anticholinergics in Older Patients With Chronic Obstructive Pulmonary DiseaseLeonardo M. Fabbri, MD, Claus Vogelmeier, MD, and Klaus F. Rabe, MDLeonardo M. Fabbri, MDFrom University of Modena and Reggio Emilia, 41124 Modena, Italy; Hospital of the Universities of Giessen and Marburg, 35043 Marburg, Germany; and Hospital Grosshansdorf, 22927 Grosshansdorf, Germany.Search for more papers by this author, Claus Vogelmeier, MDFrom University of Modena and Reggio Emilia, 41124 Modena, Italy; Hospital of the Universities of Giessen and Marburg, 35043 Marburg, Germany; and Hospital Grosshansdorf, 22927 Grosshansdorf, Germany.Search for more papers by this author, and Klaus F. Rabe, MDFrom University of Modena and Reggio Emilia, 41124 Modena, Italy; Hospital of the Universities of Giessen and Marburg, 35043 Marburg, Germany; and Hospital Grosshansdorf, 22927 Grosshansdorf, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-8-201110180-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Gershon and colleagues (1) describe an increase in death and hospitalizations in patients aged 66 years or older with chronic obstructive pulmonary disease (COPD) who fill a first prescription for the long-acting anticholinergic tiotropium bromide compared with patients who do so for a long-acting β-agonist. These results were based on information from health administrative databases in Ontario, Canada, and contrast with the authors' previous findings (2).Gershon and colleagues acknowledge the inherent limitations of this retrospective database analysis and conclude that “[f]urther research is needed to confirm these findings ... in a randomized, controlled trial.” We would ...References1. Gershon A, Croxford R, To T, Stanbrook MB, Upshur R, Sanchez-Romeu P, et al. Comparison of inhaled long-acting β-agonist and anticholinergic effectiveness in older patients with chronic obstructive pulmonary disease: a cohort study. Ann Intern Med. 2011;154:583-92. [PMID: 21536937] LinkGoogle Scholar2. Gershon AS, Wang L, To T, Luo J, Upshur RE. Survival with tiotropium compared to long-acting Beta-2-agonists in chronic obstructive pulmonary disease. COPD. 2008;5:229-34. [PMID: 18671148] CrossrefMedlineGoogle Scholar3. Vogelmeier C, Hederer B, Glaab T, Schmidt H, Rutten-van Mölken MP, Beeh KM, et al; POET-COPD Investigators. Tiotropium versus salmeterol for the prevention of exacerbations of COPD. N Engl J Med. 2011;364:1093-1103. [PMID: 21428765] CrossrefMedlineGoogle Scholar4. Boehringer Ingelheim, data on file. Google Scholar5. Drummond MB, Dasenbrook EC, Pitz MW, Murphy DJ, Fan E. Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis. JAMA. 2008;300:2407-16. Erratum in: JAMA. 2009;301:1024. [PMID: 19033591] Google Scholar Author, Article, and Disclosure InformationAffiliations: From University of Modena and Reggio Emilia, 41124 Modena, Italy; Hospital of the Universities of Giessen and Marburg, 35043 Marburg, Germany; and Hospital Grosshansdorf, 22927 Grosshansdorf, Germany.Disclosures: Dr. Fabbri has received consultancy fees from Actelion, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Elevation Pharmaceuticals, Merck Sharp & Dohme, Novartis, Nycomed, Pearl Therapeutics, Roche, and Sigma-Tau and payment for lectures and support for travel expenses from AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, EUROMEDIFORM, GlaxoSmithKline, German Centre for Lung Research, Merck Sharp & Dohme, Menarini, Mundipharma International, Novartis, Nycomed, TEVA Pharmaceuticals, Pfizer, and Sigma-Tau. His institution has received grants from Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Italian Ministry of Health, Italian Ministry for University and Research, Merck Sharp & Dohme, Nycomed, and Sigma-Tau. Dr. Vogelmeier has received consulting fees or honoraria and support for travel to meetings from Boehringer Ingelheim; is a board member for AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Mundipharma, Novartis, and Nycomed; and has received fees for expert testimony and grants from Talecris and payment for lectures or speaking from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Nycomed, and Talecris. Dr. Rabe has received consultancy fees and honoraria from, and is a board member for, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Merck Sharp & Dohme, Novartis, Nycomed, and Pfizer and has received grants from Altana, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, and Roche. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparison of Inhaled Long-Acting β-Agonist and Anticholinergic Effectiveness in Older Patients With Chronic Obstructive Pulmonary Disease Andrea Gershon , Ruth Croxford , Teresa To , Matthew B. Stanbrook , Ross Upshur , Paula Sanchez-Romeu , and Thérèse Stukel Inhaled Long-Acting β-Agonists Versus Anticholinergics in Older Patients With Chronic Obstructive Pulmonary Disease Matthew B. Stanbrook and Andrea Gershon Metrics 18 October 2011Volume 155, Issue 8Page: 561KeywordsChronic obstructive pulmonary diseaseCohort studiesDatabasesHealth information technologyHospitalizationsLungsRetrospective studies ePublished: 18 October 2011 Issue Published: 18 October 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...