Figures
- FIGURE 1.
Hypothetical model of breaking the downward spiral of COPD patients. HRQoL: health-related quality of life.
- FIGURE 2.
Inhaled bronchodilators in maintenance treatment of chronic obstructive pulmonary disease; historical evolution along the lines of evidence. Each block represents a class of inhaled bronchodilators or combination of bronchodilators as they became subsequently available on the market. The interconnecting full arrows point to the class with demonstrated superior effects on health outcomes (the evidence being provided by comparative studies referred to by the numbered references between brackets). Dashed interconnecting bi-directional arrows indicate the absence of comparative studies. SABA: short-acting β2-adrenergic receptor agonist; SAAC: short-acting anticholinergic; LAAC: long-acting anticholinergic; LABA: long-acting β2-adrenergic receptor agonist.
Tables
- TABLE 1—
Rationale for combining an anticholinergic agent and a β2-adrenergic receptor agonist
Different mechanisms of action Parasympathetic versus sympathetic system Different sites of action (?) Proximal versus distal airways Additive/synergistic effects Onset and duration of activity Limitation of dose and side-effects Improved compliance Cost-effectiveness - TABLE 2—
Patient characteristics at screening: 1-yr and 6-month trials with tiotropium
Casaburi et al. 2002 46 Vincken et al. 2002 47 Brusasco et al. 2003 50 Tio Pbo Tio Ipra Tio Sal Pbo Patients n 550 371 356 179 402 405 400 Male % 67 63 84 86 77 75 76 Age yrs 65 65 64 65 64 64 65 Duration of COPD yrs 8.6 8.1 11.4 11.2 9.0 9.9 9.8 FEV1 L 1.04 1.00 1.25 1.18 1.12 1.07 1.09 FEV1 % pred 39.1 38.1 43.9 41.4 39.2 37.7 38.7 FEV1/FVC % 45.8 45.5 45.7 45.5 43.7 42.2 42.3 Data are presented as mean, unless otherwise stated. Tio: tiotropium group; Pbo: placebo group; Ipra: ipratropium group; Sal: salmeterol group; COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in one second; FVC: forced expiratory volume.
- TABLE 3—
Global initiative for chronic obstructive lung disease objectives of COPD management: does tiotropium meet them?
Relieve symptoms Yes Improve exercise tolerance Yes Improve health status Yes Prevent and treat exacerbations Yes Prevent and treat complications ? Reduce mortality ? UPLIFT study Minimise side effects from treatment Yes Prevent disease progression ? UPLIFT study ? UPLIFT: awaiting results from the UPLIFT study. COPD: chronic obstructive pulmonary disease.
Jump To
- Article
- Abstract
- RATIONALE FOR THE USE OF ANTICHOLINERGIC AGENTS IN COPD
- INHALED SHORT-ACTING ANTICHOLINERGICS IN COPD
- THE COMBINATION OF A SAAC WITH A SABA
- LONG-ACTING β2-ADRENERGIC RECEPTOR AGONISTS IN COPD
- COMPARING LABAS TO THE SAAC IPRATROPIUM BROMIDE IN COPD
- PHARMACOLOGIC PROPERTIES OF THE LONG-ACTING ANTICHOLINERGIC TIOTROPIUM BROMIDE
- LONG-TERM CLINICAL TRIALS WITH THE LAAC TIOTROPIUM BROMIDE
- COMPARISON OF THE LAAC TIOTROPIUM BROMIDE TO THE LABA SALMETEROL
- THE COMBINATION OF A LABA WITH THE LAAC TIOTROPIUM
- TIOTROPIUM AND PHARMACOLOGICAL VOLUME REDUCTION
- DOES TIOTROPIUM AFFECT THE NATURAL COURSE OF COPD?
- CONCLUSION
- Acknowledgments
- References
- Figures & Data
- Info & Metrics