Elsevier

Respiratory Medicine

Volume 100, Issue 11, November 2006, Pages 1925-1932
Respiratory Medicine

Effect of formoterol, tiotropium, and their combination in patients with acute exacerbation of chronic obstructive pulmonary disease: A pilot study

https://doi.org/10.1016/j.rmed.2006.03.007Get rights and content
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Summary

The aim of our study was to evaluate the pharmacodynamic effects of 1-day treatment with formoterol, tiotropium and their combination in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Twenty-one (19 males, mean age 72±8 years, mean FEV1 38±14% of predicted values) patients with mild to moderate AECOPD were enrolled. Patients received formoterol (12 μg deliver via Modulite® b.i.d.), tiotropium (18 μg dry powder capsules delivered via HandiHaler® once daily), and their combination, in randomized sequence. Serial measurements of FEV1, FVC, IC, SpO2 and HR were performed over 24 h. Formoterol, tiotropium, and their combination significantly improved the area under curves (AUCs) for FEV1, FVC and IC over 12 and 24 h. The mean FEV1, FVC and IC AUC0−12 h and AUC0−24 h after formoterol and tiotropium combination were significantly higher than formoterol and tiotropium alone, whereas the differences between the two single drugs were not statistically significant. Formoterol, either alone or in combination with tiotropium, elicited a significantly faster onset of action, and combination elicited a greater maximum bronchodilation than both single drugs in terms of FEV1 and FVC. After 24 h the bronchodilating effect of the three treatments disappeared, with the exception of the combination on FEV1. The results of this study have documented that, although the time course of the effects of evaluated drugs differs significantly from that in stable COPD, with a shorter bronchodilation both for tiotropium and formoterol, these two long-acting bronchodilators appear to also be complementary in mild to moderate AECOPD.

Keywords

Acute exacerbation
Chronic obstructive pulmonary disease
Formoterol
Tiotropium
Combination therapy

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