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For Lung Disorder, Spiriva Beat Serevent in Head-to-Head Trial
Date:3/23/2011

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, March 23 (HealthDay News) -- People with moderate-to-severe chronic obstructive pulmonary disease (COPD) use inhaled long-acting bronchodilators to control symptoms and reduce flare-ups, but which type of drug is best hasn't been clear.

Now results have arrived from a new study that pitted two different popular COPD drugs against each other to determine their effectiveness at controlling the disease, which interferes with the flow of air through the lungs and airways. One of the drugs was tiotropium (Spiriva), an anticholinergic, and the other was salmeterol (Serevent), a beta-agonist.

The outcome of the trial suggests that Spiriva is more effective at preventing flare-ups, also called exacerbations.

"Prevention of exacerbations is a critical treatment goal in the care of COPD patients due to the [illness and death] attributed to exacerbations," said lead study author Dr. Claus Vogelmeier, who is from the pulmonary diseases division at University Hospital Marburg in Germany.

"The results of this trial provide data on which to base the choice of long-acting bronchodilator therapy," he added.

The report is published in the March 24 issue of the New England Journal of Medicine.

For the trial, in which neither the patients nor investigators knew which medications were assigned to the participants, Vogelmeier's group randomly assigned 7,376 patients with moderate-to-severe COPD to one of the two drugs.

During the one-year study, participants took either 18 micrograms (mcg) of Spiriva once daily or 50 mcg of Serevent twice daily. The researchers found patients using Spiriva had a lower risk of flare-ups than those using Serevent. In fact, Spiriva users reduced their risk of a first incident by 17 percent.

Spiriva also cut the number of severe flare-ups in a year and reduced the number of moderate-to-severe flare-ups compared with
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