RT Journal Article
SR Electronic
T1 Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 832
OP 840
DO 10.1183/09031936.04.00116004
VO 23
IS 6
A1 D.E. O'Donnell
A1 T. Flüge
A1 F. Gerken
A1 A. Hamilton
A1 K. Webb
A1 B. Aguilaniu
A1 B. Make
A1 H. Magnussen
YR 2004
UL http://erj.ersjournals.com/content/23/6/832.abstract
AB The aim of this study was to test the hypothesis that use of tiotropium, a new long-acting anticholinergic bronchodilator, would be associated with sustained reduction in lung hyperinflation and, thereby, would improve exertional dyspnoea and exercise performance in patients with chronic obstructive pulmonary disease. A randomised, double-blind, placebo-controlled, parallel-group study was conducted in 187 patients (forced expiratory volume in one second 44±13% pred): 96 patients received 18 µg tiotropium and 91 patients received placebo once daily for 42 days. Spirometry, plethysmographic lung volumes, cycle exercise endurance and exertional dyspnoea intensity at 75% of each patient's maximal work capacity were compared. On day 42, the use of tiotropium was associated with the following effects at pre-dose and post-dose measurements as compared to placebo: vital capacity and inspiratory capacity (IC) increased, with inverse decreases in residual volume and functional residual capacity. Tiotropium increased post-dose exercise endurance time by 105±40 s (21%) as compared to placebo on day 42. At a standardised time near end-exercise (isotime), IC, tidal volume and minute ventilation all increased, whilst dyspnoea decreased by 0.9±0.3 Borg scale units. In conclusion, the use of tiotropium was associated with sustained reductions of lung hyperinflation at rest and during exercise. Resultant increases in inspiratory capacity permitted greater expansion of tidal volume and contributed to improvements in both exertional dyspnoea and exercise endurance. This study was supported by Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany. D.E. O'Donnell holds a career scientist award from the Ontario Ministry of Health.