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Tiotropium Associated With Reduced All-Cause Mortality in Patients With COPD SAN DIEGO -- January 6, 2010 -- A study published in the January issue of the journal Chest suggests that tiotropium, a long-acting anticholinergic used in patients with chronic obstructive pulmonary disease (COPD), may be associated with a reduction in all-cause mortality, cardiovascular mortality, and cardiovascular events. Bartolome Celli, MD, Pulmonary Critical Care Division, Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues reviewed the outcomes of 30 completed clinical trials in the tiotropium project database. Within the 30 trials that were analysed, 10,846 patients with COPD were randomised to receive treatment with tiotropium and 8,699 patients were randomised to receive a placebo. Results indicated that patients treated with tiotropium had lower incidence rates (IR) of all-cause mortality, cardiovascular mortality, and cardiovascular events (IR = 3.44, .91, and 2.15 per 100 patients, respectively), compared with placebo (IR = 4.10, 1.24, and 2.67, respectively). Within the tiotropium group, the overall risk for serious or fatal lower respiratory events also was reduced. The mechanism by which tiotropium may reduce cardiovascular mortality is unclear, but researchers speculate that there may be an association with the reduction in respiratory events. SOURCE: American College of Chest Physicians E-mail this page to a friend or colleague! To print, use this version