| Abstract | BACKGROUND: Combining bronchodilators has been shown to be beneficial in patients with COPD. The additive effects of short-acting bronchodilators added to maintenance tiotropium therapy, however, are unknown. METHODS: Following 3 weeks of tiotropium pretreatment, 60 patients with COPD (FEV1 40% of predicted) participated in a randomized, placebo-controlled study to assess add-on bronchodilator effects of ipratropium bromide (40 microg) or fenoterol (200 microg). Short-acting bronchodilators were added as a single dose 2 h and 8 h after tiotropium dosing. Serial lung function tests were performed over 9 h. RESULTS: The peak FEV1 add-on response within 6 h with fenoterol was significantly greater than with placebo (137 mL) or ipratropium (84 mL); the response with ipratropium was slightly but significantly larger than with placebo (52 mL). One hour after the second dose of the test drugs, a similar order of treatment responses was found. The peak FVC add-on response was significant for fenoterol (249 mL) but not for ipratropium (42 mL). CONCLUSIONS: In conclusion, both short-acting bronchodilator classes were effective when added to maintenance treatment with tiotropium. The addition of the beta2-adrenergic fenoterol provided greater additional bronchodilatation than the short-acting anticholinergic ipratropium. This is consistent with the expected effects of combining bronchodilators with different pharmacologic mechanisms. This randomized controlled trial was registered at www.clinicaltrials.gov (NCT00274066). |
| Authors | Huib A M Kerstjens, Theo A Bantje, Peter B Luursema, Henk E J Sinninghe Damste, Jan W de Jong, Angela Lee, Stella P C Wijker, Piet J G Cornelissen
(Affiliation: Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, the Netherlands. h.a.m.kerstjens at int.umcg.nl)
|
| Journal | Chest
(Chest)
Vol. 132
Issue 5
Pg. 1493-9
(Nov 2007)
ISSN: 0012-3692 United States |
| PMID | 17890476
(Publication Type: Journal Article, Randomized Controlled Trial)
|
| Chemical References |
- Bronchodilator Agents
- Scopolamine Derivatives
- Fenoterol
- tiotropium
- Ipratropium
|
| Topics |
- Bronchodilator Agents
(administration & dosage)
- Drug Therapy, Combination
- Female
- Fenoterol
(administration & dosage)
- Forced Expiratory Volume
- Humans
- Ipratropium
(administration & dosage)
- Male
- Middle Aged
- Plethysmography
- Pulmonary Disease, Chronic Obstructive
(drug therapy)
- Respiratory Function Tests
- Scopolamine Derivatives
(administration & dosage)
- Treatment Outcome
|
