title: Tiotropium: what came after the UPLIFT study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is characterized by a progressive bronchial obstruction, and bronchodilators represent the maintenance therapeutic choice. Tiotropium is an anticholinergic drug that is proved to be safe, efficient and simple to handle; Respimat® technology was recently introduced as a new device for tiotropium administration.
  
  
  METHODS
  This paper reviews clinical trials and meta-analyses, with tiotropium efficacy as a primary end point, found in MedLine, the Cochrane trials database and Embase. Only the literature published after the UPLIFT study has been considered.
  
  
  CONCLUSIONS
  Data published after the UPLIFT study confirms the efficacy of tiotropium as maintenance COPD therapy and its capacity to reduce airflow obstruction, as well as lung hyperinflation. Nevertheless, there is a certain inhomogeneity in the definition and evaluation of COPD exacerbations, in lung functional parameters and quality-of-life assessment, and there has not always been a proper comparison between tiotropium and other long-acting bronchodilators. Respimat is comparable in efficacy to the HandiHaler®, using bioequivalent doses of tiotropium.
authors.affiliation: Università degli Studi di Milano, Pneumologia Riabilitativa - Fondazione Salvatore Maugeri, Istituto Scientifico di Riabilitazione di Milano (IRCCS), Via Camaldoli, 64, 20152 Milano, Italy. Pierachille.santus@unimi.it
authors.forename: Pierachille
authors.initials: P
authors.lastname: Santus
authors.forename: Fabiano
authors.initials: F
authors.lastname: Di Marco
authors.forename: Dejan
authors.initials: D
authors.lastname: Radovanovic
authors.forename: Stefano
authors.initials: S
authors.lastname: Centanni
mesh_terms: D001993:Bronchodilator Agents / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D006801:Humans; D015201:Meta-Analysis as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012602:Scopolamine Derivatives / Q000627:therapeutic use*; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide