Long-term bronchodilator inhaled therapy in COPD: the role of tiotropium bromidum

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lungs in which airways inflammation related mainly to smoking causes progressive airflow obstruction and chronic respiratory symptoms such as dyspnea or cough. COPD therapy in stable state is mainly inhalatory with bronchodilators and inhaled corticosteroids and the regimen depends on disease severity. Inhaled bronchodilators are the mainstay of maintenance therapy in COPD whether given alone or added to other inhaled medications. Current therapeutic guidelines are based on data from studies assessing long-term impact of such therapies on outcome measures such as lung function, survival, exacerbations or health-related quality of life (HRQoL). This is a review discussing the data regarding to inhaled bronchodilators with a focus on a long-acting anticholinergic, tiotropium bromide.