There was no difference in change in FEV1 at 12 months ( 0.003 L for LABA+ICS vs -0.018 L for tiotropium + ICS ; between-group difference , 0.020 [ 95 % CI , -0.021 to 0.061 ] , P = .33 ) and at 18 months ( -0.053 L vs -0.078 L ; between-group difference , 0.025 [ 95 % CI , -0.045 to 0.095 ] , P = .49 ) .