Association between poor therapy adherence to inhaled corticosteroids and tiotropium and morbidity and mortality in patients with COPD.

The current results on decreased mortality risk in patients who were adherent to ICSs are in line with the results of TORCH study that showed a borderline significant reduced risk on mortality with the use of fluticasone propionate combined with salmeterol. 2 This risk seems even more increased in underusers (<50%), who show an almost twofold increased mortality risk than suboptimal users (50%–75%), which implies the need to make also a distinction in the type of nonadherence.

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