Trial challenges COPD drug fears

The long-acting anticholinergic drug, marketed as Spiriva, reduced exacerbations, delayed time to first exacerbation and cut the risk of exacerbations leading to hospital admission.

However, it failed to statistically significantly reduce decline in FEV1 after four years, the trial's primary endpoint.

The finding of reduced mortality contrasts with a recent JAMA analysis suggesting anticholinergics raise CVD risk.

• NEJM 2008; 359: 1,543-54.

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