{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:23:49Z","timestamp":1789669429719,"version":"4.0.1"},"reference-count":25,"publisher":"European Respiratory Society (ERS)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2010,2,9]]},"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:p>The aim of the present study was investigate the long-term effect of tiotropium as first maintenance respiratory medication in chronic obstructive pulmonary disease (COPD).<\/jats:p><jats:p>A 4-yr, randomised, multicentre, double-blind, parallel-group, placebo-controlled trial (Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT\u00ae)) was conducted. Analysis focused on the effect of tiotropium<jats:italic>versus<\/jats:italic>matching placebo in the 810 (13.5%) COPD patients not on other maintenance treatment (long-acting \u03b2-agonists, inhaled corticosteroids, theophyllines or anticholinergics) at randomisation. Spirometry, health-related quality of life (St George\u2019s Respiratory Questionnaire (SGRQ) score), exacerbations of COPD and mortality were also analysed.<\/jats:p><jats:p>403 patients (mean\u00b1<jats:sc>sd<\/jats:sc>age 63\u00b18 yrs, post-bronchodilator forced expiratory volume in 1 s (FEV<jats:sub>1<\/jats:sub>) 53\u00b112% predicted) received tiotropium and 407 (64\u00b18 yrs of age, post-bronchodilator FEV<jats:sub>1<\/jats:sub>51\u00b112% pred) received placebo. Post-bronchodilator FEV<jats:sub>1<\/jats:sub>decline was 42\u00b14 mL\u00b7yr<jats:sup>\u22121<\/jats:sup>in the tiotropium group and 53\u00b14 mL\u00b7yr<jats:sup>\u22121<\/jats:sup>in the placebo group (p = 0.026). At 48 months, the morning pre-dose FEV<jats:sub>1<\/jats:sub>was 134 mL higher in the tiotropium group compared to the placebo group (p&lt;0.001). SGRQ total score declined more slowly in the tiotropium group (difference of 1.05\u00b10.34 units\u00b7yr<jats:sup>\u22121<\/jats:sup>; p = 0.002). This was particularly significant for the impact (difference of 1.08\u00b10.37 units\u00b7yr<jats:sup>\u22121<\/jats:sup>; p = 0.004) and activity (1.44\u00b10.40 units\u00b7yr<jats:sup>\u22121<\/jats:sup>; p&lt;0.001) domains, but not for symptoms (0.26\u00b10.50 units\u00b7yr<jats:sup>\u22121<\/jats:sup>; p = 0.6). At 48 months, the difference in total score was 4.6 units (p&lt;0.001) with tiotropium compared to placebo.<\/jats:p><jats:p>In patients with COPD who are not on maintenance therapy, tiotropium is associated with significant benefits in disease progression.<\/jats:p>","DOI":"10.1183\/09031936.00127809","type":"journal-article","created":{"date-parts":[[2010,2,26]],"date-time":"2010-02-26T01:25:47Z","timestamp":1267147547000},"page":"65-73","source":"Crossref","is-referenced-by-count":90,"title":["Tiotropium as a first maintenance drug in COPD: secondary analysis of the UPLIFT\u00ae 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