Inhaled Formoterol Dry Powder Versus Ipratropium Bromide in Chronic Obstructive Pulmonary Disease

Dahl, Ronald; Greefhorst, Louis A.P.M.; Nowak, Dariusz; Nonikov, V E; Byrne, Aidan M.; Thomson, Moira H.; Till, Denise; Cioppa, Giovanni Della

doi:10.1164/ajrccm.164.5.2007006

Cited by 317 publications

(239 citation statements)

References 24 publications

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“…Similarly, formoterol, another LABA, provided a consistent reduction in rescue medication use [25][26][27]. However, formoterol 6 or 12 mg failed to show an effect on dyspnoea, and all doses failed to improve exercise tolerance [25].…”

Section: Labasmentioning

confidence: 97%

Tiotropium as essential maintenance therapy in COPD

Decramer¹

2006

Eur Respir Rev

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Over the past decade, several large-scale clinical trials have been performed to assess the impact of pharmacological treatments on patient-centred outcomes such as dyspnoea, exercise tolerance, exacerbations and health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD).Tiotropium, a once-daily inhaled anticholinergic agent that works through prolonged muscarinic M 3 receptor blockade, has consistently been shown to provide sustained improvements in lung function parameters. Furthermore, several prospective trials have shown that tiotropium improves exercise tolerance and augments the beneficial effects of pulmonary rehabilitation. Beyond these important physiological outcomes, tiotropium has been shown to reduce dyspnoea, decrease the frequency of exacerbations and improve HRQoL in studies of f1 yr in duration. Such improvements in patient-centred outcomes may allow patients to increase their activity levels, thereby interrupting the downward spiral of chronic inactivity that leads to physical deconditioning and further reductions in exercise tolerance.Recently, combination therapies of two long-acting bronchodilators have been examined more closely regarding their potential to provide patients with superior symptom relief compared with that provided by single-agent therapy.Because maintenance treatment with tiotropium provides consistent and sustained improvements in many relevant clinical outcomes of chronic obstructive pulmonary disease, it may reduce the progression of the disease. This hypothesis is being tested in the ongoing Understanding the Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial.

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Section: Labasmentioning

confidence: 97%

Tiotropium as essential maintenance therapy in COPD

Decramer¹

2006

Eur Respir Rev

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“…Tashkin et al [2008] reported that FFIS was well tolerated when combined with tiotropium maintenance therapy for twelve weeks. Other controlled studies of formoterol dry powder inhaler treatment for COPD of 12 to 26-week duration reported similar safety results [Campbell et al 2005;Aalbers et al 2002;Dahl et al 2001].…”

Section: Discussionmentioning

confidence: 67%

Long-term safety of nebulized formoterol: Results of a twelve-month open-label clinical trial

Donohue

Hanania

Fogarty

et al. 2008

Ther Adv Respir Dis

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Formoterol fumarate is a long-acting β 2 -agonist that is an effective bronchodilator for the maintenance management of patients with chronic obstructive pulmonary disease. The safety profile of the newly developed nebulized formoterol was evaluated over a twelve-month period in an open-label, active-control study. After completing a twelve-week double-blind doubledummy period, 569 subjects with chronic obstructive pulmonary disease entered an open-label extension study and received twice-daily 20 µg formoterol fumarate inhalation solution for nebulization (FFIS) or 12 µg formoterol fumarate dry powder inhalation (FA) for 52 weeks. Most of the FFIS-treated subjects (86%) completed at least six months of open-label treatment with over 90% compliance, comparable to the FA group (88%). Results of safety monitoring for adverse events, laboratory values, and cardiac changes were similar between treatment groups. Three hundred forty (73%) of FFIS-treated subjects and 83 (78%) of FA-treated subjects experienced an adverse event over the course of the study, the majority of which were mild to moderate and considered unrelated to treatment. COPD exacerbation occurred in 15.8% of FFIS-treated and 17.9% of FA-treated subjects. Deaths, serious adverse events, and discontinuations for adverse events occurred in 1.3, 16.2, and 5.4% of the nebulized group versus 1.9, 17.9, and 7.5% of the inhaled group, respectively. There were no clinically important changes from baseline in laboratory tests, including serum potassium and glucose, or vital signs and no treatment-related increases in cardiac arrhythmias, heart rate, or QTc prolongation. We conclude that nebulized formoterol fumarate twice daily is well tolerated over long-term treatment in moderate-to-severe COPD subjects and has a similar safety profile to the DPI formulation.

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“…The long-acting muscarinic receptor antagonist tiotropium has been shown significantly to improve lung function, dyspnoea, exercise tolerance, and health related quality of life in patients with COPD, relative to placebo [16][17][18]. The two currently available LABAs -salmeterol and formoterol -also show significant improvements in lung function, health status, and symptom reduction, compared with both placebo [19][20][21][22] and ipratropium [23,24].…”

Section: Treatment Options For Copdmentioning

confidence: 99%

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Schayck

Reid

2006

Primary Care Respiratory Journal

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Summary Chronic obstructive pulmonary disease (COPD) is the internationally preferred term for chronic, progressive lung disorders which are characterised by airflow limitation that is not fully reversible. The symptoms of COPD -including breathlessness, cough, excessive sputum production and reduced muscle tone and muscle wasting -reflect the complex pathophysiology of the disease. In order to address these symptoms, treatment regimens should take into account the multiple components that contribute to COPD. Clinical evidence has emerged indicating that, especially in patients with severe COPD, long-acting beta 2 -agonists (LABAs) and inhaled corticosteroids (ICS) result in improvements in symptoms, reduce the frequency and severity of exacerbations, and improve health-related quality of life. This review evaluates the clinical evidence for the potential of LABA/ICS treatment to address the symptoms of COPD and whether combination therapy of this nature adds significant benefit to patients.

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Inhaled Formoterol Dry Powder Versus Ipratropium Bromide in Chronic Obstructive Pulmonary Disease

Cited by 317 publications

References 24 publications

Tiotropium as essential maintenance therapy in COPD

Tiotropium as essential maintenance therapy in COPD

Long-term safety of nebulized formoterol: Results of a twelve-month open-label clinical trial

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

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