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The Prevention of Exacerbations with Tiotropium in COPD (POET-COPD) trial was specifically designed to directly compare the effects of tiotropium with those of salmeterol on the risk of moderate and severe exacerbations.
A FEV1 of 70% of the predicted value or less
At least one treated exacerbation in the previous year
High use of concomitant medications among the patients in this trial.
With respect to exacerbation outcomes, tiotropium, administered once daily, is superior to salmeterol, administered twice daily.
However, novel, once-daily, long-acting β2-agonists such as indacaterol are now becoming available in Europe, and there is some evidence that outcomes with indacaterol are similar to those with tiotropium.
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