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The UPLIFT study, a landmark, randomized, double-blind, placebo-controlled study evaluating the efficacy of SPIRIVA HandiHaler (tiotropium bromide(136310-93-5)) in the long-term efficacy of tiotropium Ammonium dry powder inhalation) in patients with moderate to severe COPD. The study lasted for 4 years and included nearly 6,000 patients. Studies have shown that treatment with SPIRIVA compared with placebo resulted in sustained improvement in lung function over a four-year period and a delay in the first acute exacerbation (median time from 12.5 months to 16.7 months) . Although SPIRIVA therapy did not significantly slow the annual decline in lung function (the primary end point of the study), the UPLIFT study reaffirmed the long-term safety profile of the proven SPIRIVA. Another report at the annual meeting was a retrospective subgroup analysis of the UPLIFT study under the current GOLD guidelines, which was rated as low-risk COPD patients (ie, GOLD comprehensive assessment A and B). In the SPIRIVA-treated group, the number of acute exacerbations in patients treated with SPIRIVA decreased (FEV1> 50% predicted airflow limitation, 0-1 acute exacerbation in 4 years) compared with placebo. The St. George Respiratory Questionnaire (SGRQ) score improved significantly after 4 years in the SPIRIVA-treated group compared with placebo (-3.63, p <0.0001). The acute exacerbation rate in the SPIRIVA group was 24%, significantly lower than in the placebo group (HR = 0.76, P <0.0001); the mean annual incidence of acute exacerbation was 28%, compared with the placebo group Significantly reduced (RR = 0.72, P <0.0001).

For the first time published a 52-week WISDOM (in the ideal bronchodilation management inhaled glucocorticoid withdrawal) research data. This study evaluated the effect of discontinuing inhaled corticosteroids on the basis of tiotropium bromide(136310-93-5) and long-acting beta2 agonist therapy in severe to very severe COPD patients with a history of acute exacerbations. The results were published in the journal NEJM.

The WISDOM results suggest that in patients with moderate to severe acute exacerbations, many patients with chronic obstructive pulmonary disease may not benefit from treatment with an inhaled glucocorticosteroid based on tiotropium bromide(136310-93-5) and long-acting beta2 agonist therapy.


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