The new anticholinergic agent tiotropium bromide is an effective bronchodilator in chronic obstructive pulmonary disease (COPD) and appears to be superior to the long-acting β2-agonist salmeterol in a number of disease measures, according to data released at the European Respiratory Society meeting [Berlin, Germany; September 2001]. In a 6-month study by researchers from Boehringer Ingelheim, tiotropium bromide ['Spiriva'] significantly improved lung function, as measured by FEV1, relative to salmeterol and placebo. Dyspnoea and health-related quality of life (HRQL) were also improved by tiotropium bromide, compared to placebo, whereas salmeterol showed no significant benefits over placebo. Tiotropium bromide acts via prolonged M3-receptor antagonism and offers an advantage over standard therapies for COPD in that it is administered once daily, rather than twice daily, thereby improving patient compliance. The agent, approved in Switzerland last month, is the first once-daily therapy for COPD to hit the market.