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Additive effects of transdermal tulobuterol to inhaled tiotropium in patients with COPD.
Respir Med. 2010 Feb; 104(2):267-74.RM

Abstract

BACKGROUND

The current mainstream treatment for COPD is bronchodilators alone or in combination. The effects of a beta(2)-agonist, tulobuterol, administered transdermally, have been reported to last for 24h. However, there are no reports on the efficacy of tulobuterol combined with an anticholinergic. In this study, we investigated the efficacy and safety of transdermal tulobuterol combined with inhaled tiotropium in COPD.

METHODS

After a 2-week run-in period, 103 stable COPD patients aged >or=40 years were randomized into two groups: inhaled tiotropium (18microg, Tio group) or transdermal tulobuterol (2mg) combined with inhaled tiotropium (18microg, Tio+Tulo group) for 8 weeks. Primary endpoints were pulmonary function and severity of dyspnea. The St. George's Respiratory Questionnaire (SGRQ) score was a secondary endpoint.

RESULTS

In both groups, FEV(1) and FVC as well as dyspnea improved significantly after 8 weeks. In a comparison of both groups, percentage changes in IC and morning and evening peak expiratory flow were significantly greater in the Tio+Tulo group than in the Tio group. In addition, significant improvement in SGRQ score was observed in the Tio+Tulo group only. The risk of adverse events related to the study drugs was not increased.

CONCLUSION

In COPD patients, additional administration of transdermal tulobuterol to inhaled tiotropium produced significant benefits in dyspnea and SGRQ score as well as pulmonary function. These benefits may be due to a reduction in pulmonary hyperinflation resulting from improvement of peripheral airflow obstruction through tulobuterol via the systemic circulation.

Authors+Show Affiliations

Third Department of Internal Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan. masakazu@wakayama-med.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

19875277

Citation

Ichinose, Masakazu, et al. "Additive Effects of Transdermal Tulobuterol to Inhaled Tiotropium in Patients With COPD." Respiratory Medicine, vol. 104, no. 2, 2010, pp. 267-74.
Ichinose M, Seyama K, Nishimura M, et al. Additive effects of transdermal tulobuterol to inhaled tiotropium in patients with COPD. Respir Med. 2010;104(2):267-74.
Ichinose, M., Seyama, K., Nishimura, M., Fukuchi, Y., Nagai, A., Mishima, M., & Kubo, K. (2010). Additive effects of transdermal tulobuterol to inhaled tiotropium in patients with COPD. Respiratory Medicine, 104(2), 267-74. https://doi.org/10.1016/j.rmed.2009.09.012
Ichinose M, et al. Additive Effects of Transdermal Tulobuterol to Inhaled Tiotropium in Patients With COPD. Respir Med. 2010;104(2):267-74. PubMed PMID: 19875277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additive effects of transdermal tulobuterol to inhaled tiotropium in patients with COPD. AU - Ichinose,Masakazu, AU - Seyama,Kuniaki, AU - Nishimura,Masaharu, AU - Fukuchi,Yoshinosuke, AU - Nagai,Atsushi, AU - Mishima,Michiaki, AU - Kubo,Keishi, AU - ,, Y1 - 2009/10/28/ PY - 2009/05/20/received PY - 2009/08/27/revised PY - 2009/09/19/accepted PY - 2009/10/31/entrez PY - 2009/10/31/pubmed PY - 2010/9/24/medline SP - 267 EP - 74 JF - Respiratory medicine JO - Respir Med VL - 104 IS - 2 N2 - BACKGROUND: The current mainstream treatment for COPD is bronchodilators alone or in combination. The effects of a beta(2)-agonist, tulobuterol, administered transdermally, have been reported to last for 24h. However, there are no reports on the efficacy of tulobuterol combined with an anticholinergic. In this study, we investigated the efficacy and safety of transdermal tulobuterol combined with inhaled tiotropium in COPD. METHODS: After a 2-week run-in period, 103 stable COPD patients aged >or=40 years were randomized into two groups: inhaled tiotropium (18microg, Tio group) or transdermal tulobuterol (2mg) combined with inhaled tiotropium (18microg, Tio+Tulo group) for 8 weeks. Primary endpoints were pulmonary function and severity of dyspnea. The St. George's Respiratory Questionnaire (SGRQ) score was a secondary endpoint. RESULTS: In both groups, FEV(1) and FVC as well as dyspnea improved significantly after 8 weeks. In a comparison of both groups, percentage changes in IC and morning and evening peak expiratory flow were significantly greater in the Tio+Tulo group than in the Tio group. In addition, significant improvement in SGRQ score was observed in the Tio+Tulo group only. The risk of adverse events related to the study drugs was not increased. CONCLUSION: In COPD patients, additional administration of transdermal tulobuterol to inhaled tiotropium produced significant benefits in dyspnea and SGRQ score as well as pulmonary function. These benefits may be due to a reduction in pulmonary hyperinflation resulting from improvement of peripheral airflow obstruction through tulobuterol via the systemic circulation. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/19875277/Additive_effects_of_transdermal_tulobuterol_to_inhaled_tiotropium_in_patients_with_COPD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(09)00311-4 DB - PRIME DP - Unbound Medicine ER -