Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease?
Authors: Timothy J. Wilt, Dennis Niewoehner, Roderick MacDonald, Robert L. Kane
Journal: Annals of Internal Medicine (2008)

Letters15 April 2008Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease?Timothy J. Wilt, MD, MPH, Dennis Niewoehner, MD, Roderick MacDonald, MS, and Robert L. Kane, MDTimothy J. Wilt, MD, MPHFrom Minneapolis Veterans' Affairs Medical Center, Minneapolis, MN 55417, and University of Minnesota, Minneapolis, MN 55409.Search for more papers by this author, Dennis Niewoehner, MDFrom Minneapolis Veterans' Affairs Medical Center, Minneapolis, MN 55417, and University of Minnesota, Minneapolis, MN 55409.Search for more papers by this author, Roderick MacDonald, MSFrom Minneapolis Veterans' Affairs Medical Center, Minneapolis, MN 55417, and University of Minnesota, Minneapolis, MN 55409.Search for more papers by this author, and Robert L. Kane, MDFrom Minneapolis Veterans' Affairs Medical Center, Minneapolis, MN 55417, and University of Minnesota, Minneapolis, MN 55409.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-8-200804150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Oba for his comments, in which he concludes that tiotropium is the preferred therapy for management of chronic, stable COPD. His conclusion is based on a meta-analysis of 4 tiotropium studies demonstrating a −6% risk difference (95% CI, −10% to −2%) in the annual rate of hospitalizations compared with placebo, as well as a lack of a statistically significant reduction against placebo for studies of inhaled corticosteroids or LABAs that reported this outcome. We described similar findings in our review. The proportion of participants requiring hospitalization for COPD was lower with tiotropium than with placebo ...References1. Lau J, Ioannidis JP, Terrin N, Schmid CH, Olkin I. The case of the misleading funnel plot. BMJ. 2006;333:597-600. [PMID: 16974018] CrossrefMedlineGoogle Scholar2. Qaseem A, Snow V, Shekelle P, Sherif K, Wilt TJ, Weinberger S, et al. Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2007;147:633-8. [PMID: 17975186] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Timothy J. Wilt, MD, MPH; Dennis Niewoehner, MD; Roderick MacDonald, MS; Robert L. Kane, MDAffiliations: From Minneapolis Veterans' Affairs Medical Center, Minneapolis, MN 55417, and University of Minnesota, Minneapolis, MN 55409.Disclosures:Consultancies: D. Niewoehner (Boehringer Ingelheim, AstraZeneca, GlaxoSmithKline, Sanofi-Aventis, Schering-Plough, Adams Respiratory Therapeutics). Honoraria: D. Niewoehner (Pfizer, Boehringer Ingelheim). Grants received: D. Niewoehner (Boehringer Ingelheim, GlaxoSmithKline). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Stable Chronic Obstructive Pulmonary Disease: A Systematic Review for a Clinical Practice Guideline Timothy J. Wilt , Dennis Niewoehner , Roderick MacDonald , and Robert L. Kane Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline from the American College of Physicians Amir Qaseem , Vincenza Snow , Paul Shekelle , Katherine Sherif , Timothy J. Wilt , Steven Weinberger , Douglas K. Owens , and Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease? Yuji Oba Metrics Cited byCurrent World Literature 15 April 2008Volume 148, Issue 8Page: 626-627KeywordsChronic obstructive pulmonary diseaseConflicts of interestCorticosteroid therapyHealth statisticsHospitalizationsRisk management ePublished: 15 April 2008 Issue Published: 15 April 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...