Tuberc Respir Dis.
2005 May;58(5):498-506.
A Comparison of Tiotropium 18microgram, Once Daily and Ipratropium 40microgram, 4 Times Daily in a Double-Blind, Double-Dummy, Efficacy and Safety Study in Adults with Chronic Obstructive Pulmonary Disease
- Affiliations
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- 1Department of Internal Medicine, Catholic University, Korea. cmcpsh@catholic.ac.kr
- 2Department of Internal Medicine, Korea University, Korea.
- 3Department of Internal Medicine, Yonsei University, Korea.
- 4Department of Internal Medicine, Kyungpook University, Korea.
- 5Department of Internal Medicine, Hanyang University, Korea.
- 6Department of Internal Medicine, Kyung Hee University, Korea.
- 7Department of Internal Medicine, Sungkyunkwan University, Korea.
- 8Department of Internal Medicine, Chonbuk University, Korea.
- 9Department of Internal Medicine, Seoul University, Korea.
- 10Department of Internal Medicine, Pusan University, Korea.
- 11Department of Internal Medicine, Yonsei Wonju University, Korea.
- 12Department of Internal Medicine, ChungAng University, Korea.
- 13Department of Internal Medicine, Ulsan University, Korea.
- 14Department of Internal Medicine, Chungnam University, Korea.
- 15Department of Internal Medicine, Chonnam University, Korea.
- 16Department of Internal Medicine, National Medical Center, Korea.
Abstract
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BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD).
METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28.
RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium.
CONCLUSION
This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Keyword
MeSH Terms
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Adult*
Albuterol
Bronchodilator Agents
Capsules
Forced Expiratory Volume
Humans
Inhalation
Ipratropium*
Lung
Mass Screening
Metered Dose Inhalers
Outcome Assessment (Health Care)
Peak Expiratory Flow Rate
Pulmonary Disease, Chronic Obstructive*
Surveys and Questionnaires
Vital Capacity
Tiotropium Bromide
Albuterol
Bronchodilator Agents
Capsules
Ipratropium
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