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UPLIFT
About the Trial
The Understanding Potential Long Term Impacts on Function with Tiotropium trial randomized 5,993 COPD patients to the once daily anticholinergic tiotropium or placebo for 4 years. Tiotropium did not slow the rate of lung function decline, the primary endpoint, but improved lung function, quality of life, and exacerbations, with mortality about 16 percent lower on treatment, not significant in the main analysis. No increased cardiovascular risk emerged, countering earlier safety alarms. UPLIFT established long acting muscarinic antagonists as COPD foundation therapy, addable to LABA and ICS. It also proved 4 year randomized COPD trials feasible and reframed COPD as partially modifiable rather than relentlessly progressive.
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