The data coming from the review support the efficacy of long acting bronchodilators in improving HRQoL/HS of COPD patients. Further research evaluating HRQoL/HS as primary outcome and according to guidelines on Patient Reported Outcomes is needed.
Tiotropium significantly reduced the risk and rates of exacerbations and hospitalizations among US patients with COPD.
Conclusions Provent cannot be recommended as an alternative short-term therapy for patients with moderate to severe OSA already on CPAP.
via The effects of Provent on moderate to severe obstructive sleep apnoea during continuous positive airway pressure therapy withdrawal: a randomised controlled trial — Rossi et al. 68 (9): 854 — Thorax.
International treatment guidelines to reduce symptoms and reduce the risk of acute exacerbations exist. Relief of dyspnea and control of anxiety are important. The approach to each patient is best individualized. Earlier use of palliative care should be considered when traditional pharmacotherapy fails to achieve outcome measures and before consideration of end-of-life issues.