Effects of Tiotropium With and Without Formoterol on Airflow Obstruction and Resting Hyperinflation in Patients With COPD
| Autor: | E. Janssens, Achim Mueller, P.J.G. Cornelissen, J.J. Smeets, Jan A. van Noord, Jan Verhaert, Joseph L. Aumann |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Evening Vital Capacity Scopolamine Derivatives Critical Care and Intensive Care Medicine Parasympatholytic Cholinergic Antagonists Pulmonary Disease Chronic Obstructive FEV1/FVC ratio Forced Expiratory Volume Formoterol Fumarate medicine Humans Tiotropium Bromide Aged COPD Cross-Over Studies business.industry Tiotropium bromide Adrenergic beta-Agonists Middle Aged respiratory system medicine.disease Crossover study humanities Bronchodilator Agents Circadian Rhythm respiratory tract diseases Treatment Outcome Ethanolamines Spirometry Anesthesia Salbutamol Drug Therapy Combination Female Formoterol Cardiology and Cardiovascular Medicine business human activities circulatory and respiratory physiology medicine.drug |
| Zdroj: | Chest. 129:509-517 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.129.3.509 |
| Popis: | The combination of short-acting beta(2)-agonists and anticholinergics in the treatment of COPD has been well documented, but data on combination of long-acting agents are lacking.A randomized, open-label, placebo-controlled, three-way crossover study was conducted comparing 2-week treatment periods of tiotropium alone to tiotropium plus formoterol once or twice daily following a 2-week pretreatment period with tiotropium. Lung function (FEV(1), FVC, and resting inspiratory capacity [IC]) serially over 24 h was measured in 95 patients with stable COPD at baseline and after 2 weeks of each treatment.Mean baseline FEV(1) was 1.05 L (38% of predicted). There was a circadian variation in FEV(1), FVC, and IC at baseline that was maintained during all treatment periods. Average FEV(1) (0 to 24 h) improved by 0.08 L with tiotropium, by 0.16 L with tiotropium plus formoterol once daily, and by 0.20 L with tiotropium plus formoterol twice daily (p0.01 for all comparisons). Compared with tiotropium alone, add-on formoterol in the morning produced improvement in FEV(1), FVC, and IC for12 h. The second add-on dose of formoterol in the evening caused further improvement in FEV(1) for 12 h, but in FVC and IC for12 h. Peak increase in FEV(1) was 0.23 L (22% of baseline) with tiotropium and 0.39 L (37% of baseline) with tiotropium plus formoterol (p0.0001). Compared with tiotropium alone, add-on formoterol once and twice daily reduced the use of rescue salbutamol during the daytime (p0.01) and with add-on formoterol twice daily also during the nighttime (p0.05). The combination of tiotropium and formoterol was well tolerated.In the treatment of COPD, there is benefit from adding formoterol once or twice daily to tiotropium once daily in terms of improvement in airflow obstruction, resting hyperinflation, and the use of rescue salbutamol. |
| Databáze: | OpenAIRE |
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