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Does Tiotropium Reduce Hospitalizations in Chronic Obstructive Pulmonary Disease?
- Timothy J. Wilt, MD, MPH;
- Dennis Niewoehner, MD;
- Roderick MacDonald, MS; and
- Robert L. Kane, MD
- From Minneapolis Veterans' Affairs Medical Center, Minneapolis, MN 55417, and University of Minnesota, Minneapolis, MN 55409.
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 (risk …
