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Tiotropium improved lung function more than ipratropium in chronic obstructive pulmonary disease

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 QUESTION: In patients with stable chronic obstructive pulmonary disease (COPD), what is the long term effectiveness and safety of tiotropium compared with those of ipratropium?


Randomised {allocation concealed*}, blinded (patient and outcome assessor),* controlled trial with 13 weeks of follow up.


14 centres in the Netherlands.


288 patients ≥40 years of age (mean age 64 y, 83% men) who were current or past smokers with a diagnosis of COPD and stable airways obstruction, an FEV1 < 65% of the predicted normal rate, and a ratio of FEV1 to forced vital capacity (FVC) of <70%. Exclusion criteria included a history of asthma, allergic rhinitis, or atopy; a recent history of myocardial infarction, heart failure, or cardiac arrhythmia requiring drug treatment; upper respiratory tract …

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  • Source of funding: Boehringer Ingelheim BV.

  • For correspondence: Dr J A van Noord, Department of Respiratory Diseases, Atrium Medisch Centrum, Henri Dunantstraat 5, 6419 PC Heerlen, the Netherlands. Fax +31 455767534.

  • * See glossary.

  • Information provided by the author.