Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease?
Authors: Yuji Oba
Journal: Annals of Internal Medicine (2008)

Letters15 April 2008Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease?Yuji Oba, MDYuji Oba, MDFrom University of Missouri, Columbia, MO 65212.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-8-200804150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Because no studies have shown a clear survival benefit with any inhaled therapies for chronic obstructive pulmonary disease (COPD), the next most important hard outcome would be hospitalization rates. In their systematic review, Wilt and colleagues (1) concluded that the reductions in hospitalizations with inhaled therapies were inconsistent, and evidence did not permit definitive conclusions about relative effectiveness. I agree that that is true with long-acting β-agonists (LABAs) and inhaled corticosteroids. However, recent meta-analyses have shown that tiotropium consistently reduced hospitalization rates in moderate-to-severe COPD (2, 3). Pooled analyses, including such recent studies as TORCH (Towards a ...References1. Wilt TJ, Niewoehner D, MacDonald R, Kane RL. Management of stable chronic obstructive pulmonary disease: a systematic review for a clinical practice guideline. Ann Intern Med. 2007;147:639-53. [PMID: 17975187] LinkGoogle Scholar2. Barr RG, Bourbeau J, Camargo CA, Ram FS. Tiotropium for stable chronic obstructive pulmonary disease: A meta-analysis. Thorax. 2006;61:854-62. [PMID: 16844726] CrossrefMedlineGoogle Scholar3. Oba Y. Cost-effectiveness of long-acting bronchodilators for chronic obstructive pulmonary disease. Mayo Clin Proc. 2007;82:575-82. [PMID: 17493425] CrossrefMedlineGoogle Scholar4. Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al; TORCH investigators. 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Niewoehner , Kathryn Rice , Claudia Cote , Daniel Paulson , J. Allen D. Cooper Jr. , Larry Korducki , Cara Cassino , and Steven Kesten Management 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 Tiotropium in Combination with Placebo, Salmeterol, or Fluticasone–Salmeterol for Chronic Obstructive Pulmonary Disease: Possible Confounding Effect of Treatment Withdrawal? Shawn D. Aaron Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease? Timothy J. Wilt , Dennis Niewoehner , Roderick MacDonald , and Robert L. Kane Metrics 15 April 2008Volume 148, Issue 8Page: 626KeywordsChronic obstructive pulmonary diseaseConflicts of interestCorticosteroid therapyHospitalizationsStatistical dataSystematic reviews ePublished: 15 April 2008 Issue Published: 15 April 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. 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