The anticholinergic drug tiotropium is more effective at forestalling exacerbations in chronic obstructive pulmonary disease than the beta-2 agonist salmeterol, according to a New England Journal of Medicine study.

International researchers (including employees of tiotropium’s manufacturer) randomized some 7400 patients with moderate-to-severe COPD. All had experienced at least one exacerbation in the previous year. Half received tiotropium once daily and half received salmeterol twice daily for 1 year. Patients were allowed to continue taking non-study COPD drugs.

The amount of time taken for the first 25% of each treatment group to have a first exacerbation — the primary outcome — was some 40 days longer in tiotropium recipients (187 vs. 145 days). Risks for moderate or severe exacerbations were also lower on tiotropium.

Source:NEJM