Video of Andy Shorr, from George Washington University in Washington, DC, with the Pulmonary and Critical Care literature update.
I want to highlight an article[1] that was in the October 17 issue of the New England Journal of Medicine. This is the TIOSPIR study, a large randomized controlled trial looking at tiotropium, our prototype of long-acting antimuscarinic agents, administered via 2 mechanisms: the HandiHaler® Boehringer Ingelheim; Ridgefield, Connecticut and the Respimat® Boehringer Ingelheim.
Tiotropium is a crucial tool in our armamentarium to address chronic obstructive pulmonary disease COPD. The original large, randomized, controlled trial that underscored the value of this molecule, the UPLIFT study,[2] made it relatively clear that this drug was important at reducing the rate of COPD exacerbations in our patients with COPD. Subsequent to that trial, a number of meta-analyses have reached conflicting results regarding the safety of tiotropium delivered either via the HandiHaler, which is what we currently use, or via the newer mechanism, the Respimat. The focus has been on cardiovascular toxicity.