efficacy and tolerability of Symbicort as an add-on treatment to Spiriva compare with Spiriva alone in patients with severe chronic obstructive pulmonary disease (COPD) - SECURE 1

Exclusion Criteria

• - A history of asthma and seasonal allergic rhinitis before 40 years of age
• - Patients who have experienced exacerbation of COPD requiring hospitalisation and /or emergency room treatment and/or a course of oral steroids and/or intravenous corticosteroids and/or antibiotics within 4 weeks prior to Visit 2 and/or during run-in period and also the patients who use of systemic glucocorticosteroids (GCS) within 4 weeks and/or inhaled GCS within 2 weeks prior to Visit 2 and/or during run-in period
• - Patients with relevant cardiovascular disorder judged by the investigator
• - Patients with glaucoma, prostatic hyperplasia or bladder-neck obstruction judged by the investigator
• - Women who are pregnant, breast-feeding or of child-bearing potential judged by the investigator