Improved daytime spirometric efficacy of tiotropium compared with salmeterol in patients with COPD

Briggs, Dick D.; Covelli, Henry D.; Lapidus, Robert; Bhattycharya, S.; Kesten, Steven; Cassino, Cara

doi:10.1016/j.pupt.2005.02.013

Cited by 78 publications

(57 citation statements)

References 13 publications

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“…Tiotropium has been formulated for once-daily dosing, providing 24-hour bronchodilation, and has a selectivity for M 1 and M 3 receptors. The clinical database for tiotropium has confirmed an excellent clinical profile for this agent, including symptom improvement, decreased hyperinflation, reduced dyspnea, and improved quality of life [24,25]. Moreover, treatment with tiotropium reduces the frequency of exacerbations [26] and improves the effectiveness of pulmonary rehabilitation [27].…”

Section: Anticholinergicsmentioning

confidence: 92%

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

Antus

2013

ISRN Pulmonology

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Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide. In addition to generating high healthcare costs, COPD imposes a significant burden in terms of disability and impaired quality of life. Unlike many leading causes of death and disability, COPD is projected to increase in many regions of the world as the frequency of smoking is rising and the population is aging. The pharmacological treatment of COPD includes bronchodilators to relax smooth muscle, such as 2 -agonists (salbutamol, terbutaline, and fenoterol, short-acting 2 -agonists as well as salmeterol, formoterol, and indacaterol, and long-acting 2 -agonists) and anticholinergics, such as ipratropium, oxitropium (short-acting anticholinergic), and tiotropium (long-acting anticholinergic). Although airway inflammation in COPD poorly responds to steroids, several inhaled corticosteroids (fluticasone, budesonide, and beclomethasone) are in use in combination with long-acting 2 -agonists. Other medications include theophylline (both a bronchodilator and a phosphodiesterase inhibitor) and the phosphodiesterase-4 antagonists, such as roflumilast. Finally, a number of novel long-acting anticholinergics and 2 -agonists with once-or twice-daily profiles are in development and clinical testing.

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Section: Anticholinergicsmentioning

confidence: 92%

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

Antus

2013

ISRN Pulmonology

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“…(31) Regarding the comparison of classes of medications, two clinical trials showed that LAMAs were superior to LABAs in terms of improving pulmonary function. (28,32) However, Aaron et al conducted a study comparing the use of LAMAs in isolation with the use of LAMAs in combination with LABAs in terms of their effects on pulmonary function and found that the LAMA-LABA combination provided no additional benefits. (33) In contrast, the use of the LAMA-LABA-IC combination was found to be superior to the use of LAMAs in isolation.…”

Section: Pulmonary Functionmentioning

confidence: 99%

“…The comparison among long-acting bronchodilators in terms of adverse effects was inconclusive. Briggs et al (32) reported that the comparison between LAMAs and salmeterol in a randomized clinical trial revealed a higher prevalence of mild adverse effects, such as dry mouth, and a lower prevalence of serious adverse effects, particularly those related to the lower respiratory tract. (32) In contrast, an observational study compared those same medications and found no differences regarding cardiac ischemic events, arrhythmias, or pneumonia.…”

Section: Mortalitymentioning

confidence: 99%

“…Briggs et al (32) reported that the comparison between LAMAs and salmeterol in a randomized clinical trial revealed a higher prevalence of mild adverse effects, such as dry mouth, and a lower prevalence of serious adverse effects, particularly those related to the lower respiratory tract. (32) In contrast, an observational study compared those same medications and found no differences regarding cardiac ischemic events, arrhythmias, or pneumonia. (68) The use of fluticasone was compared with that of salmeterol in isolation, (19,20,43,79) as well as with that of LAMAs in isolation, (69) and was shown to increase the risk of developing pneumonia.…”

Section: Mortalitymentioning

confidence: 99%

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Tratamento farmacológico da DPOC

et al. 2011

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ResumoAproximadamente sete milhões de brasileiros acima de 40 anos são acometidos pela DPOC. Nos últimos anos, importantes avanços foram registrados no campo do tratamento medicamentoso dessa condição. Foi realizada uma revisão sistemática incluindo artigos originais sobre tratamento farmacológico da DPOC publicados entre 2005 e 2009, indexados em bases de dados nacionais e internacionais e escritos em inglês, espanhol ou português. Artigos com tamanho amostral menor de 100 indivíduos foram excluídos. Os desfechos sintomas, função pulmonar, qualidade de vida, exacerbações, mortalidade e efeitos adversos foram pesquisados. Os artigos foram classificados segundo o critério da Global Initiative for Chronic Obstructive Lung Disease para nível de evidência científica (grau de recomendação A, B e C). Dos 84 artigos selecionados, 40 (47,6%), 18 (21,4%) e 26 (31,0%) foram classificados com graus A, B e C, respectivamente. Das 420 análises oriundas desses artigos, 236 referiam-se à comparação de fármacos contra placebo nos diversos desfechos estudados. Dessas 236 análises, os fármacos mais frequentemente estudados foram anticolinérgicos de longa duração, a combinação β 2 -agonistas de longa duração + corticosteroides inalatórios e corticosteroides inalatórios isolados em 66, 48 e 42 análises, respectivamente. Nas mesmas análises, os desfechos função pulmonar, efeitos adversos e sintomas geraram 58, 54 e 35 análises, respectivamente. A maioria dos estudos mostrou que os medicamentos aliviaram os sintomas, melhoraram a qualidade de vida, a função pulmonar e preveniram as exacerbações. Poucos estudos contemplaram o desfecho mortalidade, e o papel do tratamento medicamentoso nesse desfecho ainda não está completamente definido. Os fármacos estudados são seguros no manejo da DPOC, com poucos efeitos adversos.Descritores: Doença pulmonar obstrutiva crônica/terapia; Doença pulmonar obstrutiva crônica/mortalidade; Revisão. AbstractApproximately seven million Brazilians over 40 years of age have COPD. In recent years, major advances have been made in the pharmacological treatment of this condition. We performed a systematic review including original articles on pharmacological treatments for COPD. We reviewed articles written in English, Spanish, or Portuguese; published between 2005 and 2009; and indexed in national and international databases. Articles with a sample size < 100 individuals were excluded. The outcome measures were symptoms, pulmonary function, quality of life, exacerbations, mortality, and adverse drug effects. Articles were classified in accordance with the Global Initiative for Chronic Obstructive Lung Disease criteria for the determination of the level of scientific evidence (grade of recommendation A, B, or C). Of the 84 articles selected, 40 (47.6%), 18 (21.4%), and 26 (31.0%) were classified as grades A, B, and C, respectively. Of the 420 analyses made in these articles, 236 were regarding the comparison between medications and placebos. Among these 236 analyses, the most commonly studied medications (in 66...

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“…They documented that salmeterol was significantly better than ipratropium in improving lung function and health status, and at reducing symptoms at the recommended doses over a 12-week period in patients with COPD. However, data from three studies specifi cally designed to explore the potential differences between tiotropium and salmeterol seem to indicate greater effi cacy for tiotropium, a long-lasting anticholinergic agent (LAMA) [21][22][23].…”

Section: Do Patients With Asthma and Copd React Selectively To Differmentioning

confidence: 99%

Current opinion: Pharmacological approaches in asthma and COPD

Cazzola

2009

breathe

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Improved daytime spirometric efficacy of tiotropium compared with salmeterol in patients with COPD

Cited by 78 publications

References 13 publications

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

Tratamento farmacológico da DPOC

Current opinion: Pharmacological approaches in asthma and COPD

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