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Tiotropium

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https://www.readbyqxmd.com/read/29213218/tiotropium-in-asthma-back-to-the-future-of-anticholinergic-treatment
#1
REVIEW
Matteo Bonini, Nicola Scichilone
Asthma is among the most common chronic diseases worldwide; however, despite progresses in the understanding of the patho-physiological mechanisms and advances in the development of new therapeutic options and strategies, the disease remains uncontrolled in a not trivial proportion of subjects. Thus, the need of new molecules to treat the underlying biological and functional abnormalities and to control symptoms is strongly advocated by clinicians. In this scenario, the most recent GINA guidelines have included the use of tiotropium bromide in the most severe and uncontrolled forms of the disease, in addition to treatment with inhaled corticosteroid plus long acting beta adrenergic agents...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/29211676/tiotropium-in-early-stage-copd
#2
LETTER
(no author information available yet)
New England Journal of Medicine, Volume 377, Issue 23, Page 2292-2294, December 2017.
December 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29206658/lung-function-trajectories-and-chronic-obstructive-pulmonary-disease-current-understanding-and-knowledge-gaps
#3
Jamuna K Krishnan, Fernando J Martinez
PURPOSE OR REVIEW: Population-based studies have shown a significant heterogeneity in patients with chronic obstructive pulmonary disease (COPD), regarding both the attainment of maximal lung function and the subsequent decline over time. This review will highlight recent advances in the understanding of lung function trajectory in COPD, focusing on factors that influence peak adult lung function, markers of accelerated lung function decline and pharmacologic interventions in early phases of the disease...
December 4, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29200840/lung-function-and-long-term-safety-of-tiotropium-olodaterol-in-east-asian-patients-with-chronic-obstructive-pulmonary-disease
#4
Chunxue Bai, Masakazu Ichinose, Sang Haak Lee, Kwan Ho Lee, Olaf Jöns, Ulrich Bothner, Yihua Zhao, Roland Buhl
Background and purpose: While the efficacy and safety of combined tiotropium and olodaterol in patients with COPD was established in a large clinical trial program, it is important to assess whether clinical data can be applied to geographic patient groups, particularly for East Asian patients who may have a different phenotypic profile to the global trial population. This study aimed to compare the lung function and safety profiles of tiotropium/olodaterol and monocomponents in East Asian and global populations from the TONADO® trials...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29178871/efficacy-and-safety-of-tiotropium-and-olodaterol-in-copd-a-systematic-review-and-meta-analysis
#5
Marc Miravitlles, Gerard Urrutia, Alexander G Mathioudakis, Julio Ancochea
BACKGROUND: Long-acting bronchodilators are the cornerstone of pharmacologic treatment of COPD. The new combination of long-acting muscarinic antagonist (LAMA) tiotropium (TIO) and long acting beta-agonists (LABA) olodaterol (OLO) has been introduced as fist line therapy for COPD. This article analyses the evidence of efficacy and safety of the TIO/OLO combination. METHODS: A systematic review and metaanalysis of randomized controlled trials (RCT) with a period of treatment of at least 6 weeks, in patients with COPD confirmed by spirometry, comparing combined treatment with TIO/OLO (approved doses only), with any of the mono-components or any other active comparator administered as an inhalator...
November 25, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29175450/crosstalk-between-machrm3-and-%C3%AE-2ar-via-acetylcholine-pi3-pkc-pbep1-raf-1-mek1-2-erk1-2-pathway-activation-in-human-bronchial-epithelial-cells-after-long-term-cigarette-smoke-exposure
#6
Giusy Daniela Albano, Anna Bonanno, Monica Moscato, Giulia Anzalone, Caterina Di Sano, Loredana Riccobono, Sally E Wenzel, Mirella Profita
BACKGROUND: Cigarette smoke extract (CSE) affects the expression of non-neuronal components of cholinergic system in bronchial epithelial cells and, as PEBP1/Raf-mediated MAPK1/2 and ERK1/2 pathway, promotes inflammation and oxidative stress. AIMS: We studied whether Acetylcholine (ACh) is involved in the mechanism of crosstalk between mAChRM3 and β2Adrenergic receptors (β2AR) promoting, via PI3/PKC/PBEP1/Raf/MEK1/2/ERK1/2 activation, β2AR desensitization, inflammation and, oxidative stress in a bronchial epithelial cell line (16HBE) after long-term exposure to cigarette smoke extract (LECSE)...
November 22, 2017: Life Sciences
https://www.readbyqxmd.com/read/29174062/tiotropium-respimat-add-on-is-efficacious-in-symptomatic-asthma-independent-of-t2-phenotype
#7
Thomas B Casale, Eric D Bateman, Mark Vandewalker, J Christian Virchow, Hendrik Schmidt, Michael Engel, Petra Moroni-Zentgraf, Huib A M Kerstjens
BACKGROUND: Adding tiotropium to existing inhaled corticosteroid (ICS) maintenance therapy with or without a long-acting β2-agonist (LABA) has been shown to be beneficial in patients with symptomatic asthma. OBJECTIVE: To assess whether responses to tiotropium Respimat add-on therapy were influenced by patients' T2 status. METHODS: In this exploratory study, data from 4 phase III trials were analyzed: once-daily tiotropium 5 μg or placebo as add-on to ICS + LABA (PrimoTinA-asthma; 2 replicate trials; NCT00772538/NCT00776984; n = 912); once-daily tiotropium 5 μg or 2...
November 22, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29173780/approaching-current-and-new-drug-therapies-for-pediatric-asthma
#8
REVIEW
William C Anderson, Melanie C Gleason, Naomi Miyazawa, Stanley J Szefler
As new therapies for pediatric asthma are approved by the Food and Drug Administration, clinicians should be aware of their benefits and limitations. Accompanying these therapies are potential obstacles, including the delivery of inhaled therapies and age-specific issues regarding implementation and adherence. New insights are being added to well-established controller medications, including inhaled corticosteroids and long-acting β-agonists, while new medications previously approved in adults, including tiotropium and biologics, are now being evaluated for use in children...
December 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29158154/tiotropium-inhibits-mucin-production-stimulated-by-neutrophil-elastase-but-not-by-il-13
#9
Kosaku Komiya, Shuichi Kawano, Isao Suzaki, Tomohiro Akaba, Jun-Ichi Kadota, Bruce K Rubin
Tiotropium, a muscarinic antagonist, is approved for the treatment of chronic obstructive pulmonary disease and poorly controlled asthma. Because mucus hypersecretion is characteristic of both of these diseases, and muscarinic agonists stimulate mucus secretion, we hypothesized that tiotropium would attenuate airway MUC5AC expression. We grew normal human bronchial epithelial (NHBE) cells to a goblet cell phenotype with 1 or 5 ng/mL of IL-13 and exposed these cells to 10 nM tiotropium or excipient for the full 14 days...
November 17, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29153415/comparison-of-the-rapid-effects-of-single-inhalations-of-formoterol-and-tiotropium-bromide-on-respiratory-function-and-copd-symptoms-in-a-randomized-crossover-study
#10
Hiroyuki Ohbayashi
BACKGROUND: This study aimed to compare rapid improvements in respiratory function and symptoms following single inhalation of formoterol (FOM) dry power inhaler (DPI) or tiotropium bromide (TIO) DPI in patients with chronic obstructive pulmonary disease (COPD). METHODS: Fifty-two outpatients with COPD (GOLD stage 2 or 3) received either a single inhalation of FOM DPI (9 μg via a Turbuhaler®) or TIO DPI (18μg via a HandiHaler®) in a randomized crossover manner...
November 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/29138547/efficacy-of-tiotropium-and-indacaterol-monotherapy-and-their-combination-on-dynamic-lung-hyperinflation-in-copd-a-random-open-label-crossover-study
#11
Keisaku Fujimoto, Haruna Yamazaki, Midori Ura, Yoshiaki Kitaguchi
Background and objective: The difference in efficacy of long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) for dynamic lung hyperinflation (DLH) in COPD is unclear. The purpose of this study was to elucidate the difference in efficacy of LAMA and LABA alone and the combination thereof for DLH. Subjects and methods: Thirty stable patients were enrolled and randomly divided into two groups following baseline measurements. One group was treated with 5 μg tiotropium (Respimat inhaler) for 4 weeks following a 4-week treatment with 150 μg indacaterol, while the other group was treated with indacaterol for 4 weeks following a 4-week treatment with tiotropium...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29108533/a-review-of-the-efficacy-and-safety-of-once-daily-tiotropium-respimat-2-5-micrograms-in-adults-and-adolescents-with-asthma
#12
(no author information available yet)
BACKGROUND: Despite current guidelines, many patients with asthma remain symptomatic, particularly those intolerant of,unresponsive to, or uncontrolled by long-acting beta 2-agonists (LABAs). Tiotropium bromide, delivered through the Respimatsoft-mist inhaler in 2 puffs of 1.25 micrograms each, is approved for the long-term, maintenance treatment of asthma in patients aged greater than or equal to 6 years. OBJECTIVE: An overview of the use of once-daily tiotropium Respimat 2...
November 6, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29104624/smart-watch-based-coaching-with-tiotropium-and-olodaterol-ameliorates-physical-activity-in-patients-with-chronic-obstructive-pulmonary-disease
#13
Osamu Hataji, Yoichi Nishii, Kentaro Ito, Tadashi Sakaguchi, Haruko Saiki, Yuta Suzuki, Corina D'Alessandro-Gabazza, Hajime Fujimoto, Tetsu Kobayashi, Esteban C Gabazza, Osamu Taguchi
Combined therapy with tiotropium and olodaterol notably improves parameters of lung function and quality of life in patients with chronic obstructive pulmonary disease (COPD) compared to mono-components; however, its effect on physical activity is unknown. The present study evaluated whether combination therapy affects daily physical performance in patients with COPD under a smart watch-based encouragement program. This was a non-blinded clinical trial with no randomization or placebo control. A total of 20 patients with COPD were enrolled in the present study...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29094315/comparative-efficacy-of-once-daily-umeclidinium-vilanterol-and-tiotropium-olodaterol-therapy-in-symptomatic-chronic-obstructive-pulmonary-disease-a-randomized-study
#14
Gregory J Feldman, Ana R Sousa, David A Lipson, Lee Tombs, Neil Barnes, John H Riley, Sadhana Patel, Ian Naya, Chris Compton, Bernardino Alcázar Navarrete
INTRODUCTION: We report the results of the first direct comparison of the once-daily fixed-dose long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) combinations umeclidinium/vilanterol (UMEC/VI) and tiotropium/olodaterol (TIO/OLO) in patients with COPD. METHODS: This was a randomized, two-period crossover open-label study in symptomatic patients with COPD [age 40 years or older, postbronchodilator forced expiratory volume in 1 s (FEV1) of 70% or less and 50% or more of predicted normal values, and modified Medical Research Council Dyspnoea Scale score of 2 or greater] not receiving inhaled corticosteroid therapy...
November 1, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29071082/adjuncts-for-sputum-clearance-in-copd-clinical-consensus-versus-actual-use
#15
Ruth Barker, Anthony A Laverty, Nicholas S Hopkinson
INTRODUCTION: Oscillatory positive pressure devices (OPEP) can be used as adjuncts to improve sputum clearance in chronic obstructive pulmonary disease (COPD), though the evidence base is incomplete. The attitudes of physiotherapists towards these devices in the care of patients with COPD is unknown. In addition, actual use compared with the prescription of medications has not been studied. METHODS: We analysed English prescribing data, obtained from OpenPrescribing...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29062229/triple-therapy-in-copd-new-evidence-with-the-extrafine-fixed-combination-of-beclomethasone-dipropionate-formoterol-fumarate-and-glycopyrronium-bromide
#16
REVIEW
Dave Singh, Massimo Corradi, Monica Spinola, Alberto Papi, Omar S Usmani, Mario Scuri, Stefano Petruzzelli, Jørgen Vestbo
The goals of COPD therapy are to prevent and control symptoms, reduce the frequency and severity of exacerbations, and improve exercise tolerance. The triple combination therapy of inhaled corticosteroids (ICSs), long-acting beta2 agonists (LABAs), and long-acting muscarinic antagonists (LAMAs) has become an option for maintenance treatment of COPD and as a "step-up" therapy from single or double combination treatments. There is evidence that triple combination ICS/LABA/LAMA with different inhalers improves lung function, symptoms, and health status and reduces exacerbations...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29040210/anticholinergics-for-asthma-a-long-history
#17
Gustavo J Rodrigo
PURPOSE OF REVIEW: To provide a fast overview about the introduction and development of anticholinergic drugs in Western medicine to their current indications particularly in asthma. RECENT FINDINGS: Although short-acting muscarinic antagonists have been positioned in the last 15 years for the treatment of adults and children with moderate-to-severe acute asthma in the emergency setting (reducing the risk of hospital admissions and improving lung function), a growing body of evidence has recently emerged that positions the long-acting muscarinic anticholinergic tiotropium bromide as add-on therapy to at least inhaled corticosteroids (ICS) maintenance therapy in adults, adolescents, and children with symptomatic asthma...
October 16, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29030687/tolerability-of-bisoprolol-on-domiciliary-spirometry-in-copd
#18
Sunny Jabbal, Brian J Lipworth
We investigated if serial domiciliary measures of spirometry were sensitive at detecting subtle effects of beta-2 blockade associated with bisoprolol in (n = 17) patients with COPD. After a two-week run in on inhaled corticosteroid (ICS) and long acting beta-2 agonist (LABA): beclometasone/formoterol 100/6 µg, patients' started additional a long acting muscarinic receptor antagonist: (LAMA) Tiotropium 18 µg, with concomitant weekly dose titration of bisoprolol: 1.25-2.5-5 mg. After a further week of bisoprolol 5 mg, they were stepped back down to (ICS/LABA) for one week...
October 14, 2017: Lung
https://www.readbyqxmd.com/read/29025008/cardiopulmonary-interactions-with-beta-blockers-and-inhaled-therapy-in-copd
#19
S Jabbal, W Anderson, P Short, A Morrison, A Manoharan, B J Lipworth
Background: Beta-blockers remain underused in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular disease. Aim: We compared how different inhaled therapies affect tolerability of bisoprolol and carvedilol in moderate to severe COPD. Design: A randomized, open label, cross-over study. Methods: We compared the cardiopulmonary interactions of bisoprolol 5 mg qd or carvedilol 12.5 mg bid for 6 weeks in conjunction with: (i) triple: inhaled corticosteroid/long acting beta-agonist/long acting muscarinic antagonist (ICS + LABA + LAMA), (ii) dual: ICS + LABA and (iii) ICS alone...
July 24, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28982946/role-of-bronchodilation-and-pattern-of-breathing-in-increasing-expiratory-flow-during-progressive-hypercapnia-in-chronic-obstructive-pulmonary-disease
#20
Kevin E Finucane, Bhajan Singh
Hypercapnia (HC) in-vitro relaxes airway smooth muscle; in-vivo it increases respiratory effort, tidal expiratory flows (V'exp), and, by decreasing inspiratory duration (Ti), increases elastic recoil pressure (Pel) via lung visco-elasticity; however, its effect on airway resistance is uncertain. We examined the contributions of bronchodilation, Ti and expiratory effort to increasing V'exp ̇with progressive HC in 10 COPD subjects, mean FEV1 53% predicted. Lung volumes (Vl), V'exp, esophageal pressure (Pes), Ti and end tidal PCO2 (PetCO2) were measured during 6 tidal breaths followed by an inspiratory capacity (IC), breathing air and at 3 levels of HC...
October 5, 2017: Journal of Applied Physiology
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