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Review: tiotropium reduces exacerbations and hospital admissions in COPD and improves quality of life

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 Q In patients with stable chronic obstructive pulmonary disease (COPD), is tiotropium more effective than placebo or other bronchodilators for reducing the risk of clinical end points?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Respirology ★★★★★☆☆


Embedded ImageData sources:

Cochrane Airways Review Group specialised register, the Cochrane Central Register of Controlled Trials, Medline, EMBASE/Excerpta Medica, CINAHL, LILACS (to October 2004); hand searching 20 respiratory journals, conference abstracts, and bibliographies of relevant studies; and contacting authors.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) in any language that included patients >35 years of age with known stable COPD without evidence of an exacerbation for 1 month before study entry, and compared tiotropium with placebo, ipratropium bromide, or long acting β agonists (salmeterol or formoterol) for ⩾1 month. Studies of patients with diseases other than COPD, previous asthma, cystic fibrosis, bronchiectasis, or other …

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  • For correspondence: Dr R G Barr, Columbia-Presbyterian Medical Center, New York, NY, USA. rgb9{at}

  • Source of funding: no external funding.