• COPD Pharmacology

We thank Dr Lipworth1 for his response to our editorial,2 which we emphasise related to the safety of tiotropium by Respimat, not by Handihaler. We agree that UPLIFT provides very reassuring data regarding the safety of tiotropium administered by the Handihaler device in a chronic obstructive pulmonary disease (COPD) population from which people with significant diseases other than COPD, which could compromise participation or put the patient at risk, were excluded. Patients with a range of commonly encountered comorbidities, including myocardial infarction in the recent 6 months, unstable arrhythmia or hospitalisation for heart failure in the recent 12 months, or need for oxygen therapy >12 h/day, and moderate renal impairment were not eligible for UPLIFT, thereby limiting the generalisability of the findings. We also …