Slowing the disease progression by altering the rate of decline
in FEV is seen as a clinically meaningful treatment goal in COPD
and is a marker of the natural history of the disease. Tiotropium
(SPIRIVA) has consistently demonstrated improvements in lung
function, dyspnea, health related quality of life and exacerbations
in trials of up to one year in duration. The post-hoc analysis from
Anzueto et al suggested that tiotropium can alter the rate of decline
in FEV over a one year period. This finding, in addition to the
other recognized benefits of SPIRIVA led to the UPLIFT hypothesis,
that tiotropium can alter the rate of decline in FEV and may have
long-term impacts on the course of COPD.



References can be found here