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Authors’ reply to ‘Explaining differential effects of tiotropium on mortality in COPD’
  1. Christine Jenkins1,
  2. Richard Beasley2
  1. 1 The George Institute for Global Health, Sydney, Australia
  2. 2 Medical Research Institute of New Zealand, Wellington, New Zealand
  1. Correspondence to Dr Christine R Jenkins, The George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, NSW 2050, Australia; christine.jenkins{at}

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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 …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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