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Tiotropium

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https://www.readbyqxmd.com/read/29670674/tiotropium-for-the-treatment-of-asthma-patient-selection-and-perspectives
#1
REVIEW
V Madhu Chari, Robert Andrew McIvor
Asthma is a chronic disease of airway inflammation with a large global burden. Despite established, guideline-based stepwise therapy, a significant proportion of patients remain symptomatic and poorly controlled. As such, there is a need for additional safe, effective, convenient, and cost-effective therapies that can be broadly applied across a range of asthma phenotypes. Tiotropium is a long-acting muscarinic antagonist (LAMA) that leads to bronchodilation by blocking endogenous acetylcholine receptors in the airways...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29670345/practical-considerations-when-prescribing-a-long-acting-muscarinic-antagonist-for-patients-with-copd
#2
REVIEW
Anthony D D'Urzo, Peter Kardos, Russell Wiseman
COPD is characterized by persistent airflow limitation, progressive breathlessness, cough, and sputum production. Long-acting muscarinic antagonists (LAMAs) are one of the recommended first-choice therapeutic options for patients with COPD, and several new agents have been developed in recent years. A literature search identified 14 published randomized, placebo-controlled studies of the efficacy and safety of LAMAs in patients with COPD, with improvements seen in lung function, exacerbations, breathlessness, and health status...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29670344/cost-effectiveness-analysis-of-a-fixed-dose-combination-of-indacaterol-and-glycopyrronium-as-maintenance-treatment-for-copd
#3
Ming-Cheng Chan, Elise Chia-Hui Tan, Ming-Chin Yang
Objective: The aim of this study was to evaluate the cost-effectiveness of the long-acting beta-2 agonist (LABA)/long-acting muscarinic antagonist (LAMA) dual bronchodilator indacaterol/glycopyrronium (IND/GLY) as a maintenance treatment for COPD patients from the perspective of health care payer in Taiwan. Patients and methods: We adopted a patient-level simulation model, which included a cohort of COPD patients aged ≥40 years. The intervention used in the study was the treatment using IND/GLY, and comparators were tiotropium or salmeterol/fluticasone combination (SFC)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29664681/effect-of-bronchodilation-and-exercise-training-with-behavior-modification-on-exercise-tolerance-and-downstream-effects-on-symptoms-and-physical-activity-in-copd
#4
Thierry Troosters, François Maltais, Nancy Leidy, Kim L Lavoie, Maria Sedeno, Wim Janssens, Judith Garcia-Aymerich, Damijan Erzen, Dorothy De Sousa, Lawrence Korducki, Alan Hamilton, Jean Bourbeau
RATIONALE: Bronchodilation and exercise training (ExT) improve exercise tolerance in patients with chronic obstructive pulmonary disease (COPD); however, behavior modification is required to impact on daily physical activity (PA). OBJECTIVES: To assess whether tiotropium/olodaterol, ±ExT, would improve exercise endurance time (EET) and PA compared with placebo in patients participating in a self-management behavior-modification (SMBM) program. METHODS: A 12-week, randomized, partially double-blind, placebo-controlled, parallel-group trial in patients with COPD (PHYSACTO®; NCT02085161)...
April 17, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29629403/effectiveness-of-umeclidinium-vilanterol-for-protocolized-management-of-chronic-obstructive-pulmonary-disease-exacerbation-in-hospitalized-patients-a-sequential-period-analysis
#5
Todd W Chapin, Michael A Mann, Gary L Brown, Traci L Leitheiser, Becky Anderson, David D Leedahl
Background: Bronchodilator therapy is a foundation of chronic obstructive pulmonary disease (COPD) exacerbation treatment. Although international guidelines recommend short-acting formulations given multiple times per day, long-acting formulations have not been adequately evaluated. The objective of our study was to determine the effectiveness of umeclidinium-vilanterol (UME/VIL), long-acting beta2-agonist/long-acting muscarinic antagonist (LABA/LAMA) as a once-daily alternative for treating COPD exacerbations in hospitalized patients...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29605624/tiotropium-and-olodaterol-in-the-prevention-of-chronic-obstructive-pulmonary-disease-exacerbations-dynagito-a-double-blind-randomised-parallel-group-active-controlled-trial
#6
Peter M A Calverley, Antonio R Anzueto, Kerstine Carter, Lars Grönke, Christoph Hallmann, Christine Jenkins, Jadwiga Wedzicha, Klaus F Rabe
BACKGROUND: Combinations of long-acting bronchodilators are recommended to reduce the rate of chronic obstructive pulmonary disease (COPD) exacerbations. It is unclear whether combining olodaterol, a long-acting beta-agonist, with tiotropium, a long-acting anti-muscarinic, reduces the rate of exacerbations compared with tiotropium alone. METHODS: This 52-week, double-blind, randomised, parallel-group, active-controlled trial randomly assigned (1:1) patients with COPD with a history of exacerbations using a randomised block design to receive tiotropium-olodaterol 5 μg-5 μg or tiotropium 5 μg once daily...
March 28, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29605203/in-vitro-and-clinical-characterization-of-the-valved-holding-chamber-aerochamber-plus-%C3%A2-flow-vu-%C3%A2-for-administrating-tiotropium-respimat-%C3%A2-in-1-5-year-old-children-with-persistent-asthmatic-symptoms
#7
Herbert Wachtel, Mark Nagel, Michael Engel, Georges El Azzi, Ashish Sharma, Jason Suggett
BACKGROUND: When characterizing inhalation products, a comprehensive assessment including in vitro, pharmacokinetic (PK), and clinical data is required. We conducted a characterization of tiotropium Respimat® when administered with AeroChamber Plus® Flow-Vu® anti-static valved holding chamber (test VHC) with face mask in 1-5-year-olds with persistent asthmatic symptoms. METHODS: In vitro tiotropium dose and particle size distribution delivered into a cascade impactor were evaluated under fixed paediatric and adult flow rates between actuation and samplings...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29583021/copd-2017-a-year-in-review
#8
Ernesto Crisafulli, Antoni Torres
In this review, we focused on original manuscripts published in the 2017 that provided additional information on the clinical and therapeutic features of the chronic obstructive pulmonary disease (COPD). We have chosen eight of these studies, collected in four topics concerning the pharmacological treatment (tiotropium) of mild-moderate patients, the pharmacological (fluticasone furoate/vilanterol/umeclidinium) and non-pharmacological treatment (non-invasive mechanical ventilation) of severe patients, the etiology of acute exacerbation of COPD involving seasonal airway pathogens and the role of eosinophils with particular interest to the monoclonal antibody directed against interleukin-5 (mepolizumab)...
March 27, 2018: COPD
https://www.readbyqxmd.com/read/29582435/combining-long-acting-bronchodilators-with-different-mechanisms-of-action-a-pharmacological-approach-to-optimize-bronchodilation-of-equine-airways
#9
L Calzetta, P Rogliani, E Pistocchini, M Mattei, G Cito, P Alfonsi, C Page, M G Matera
The ultra long-acting β2 -adrenoceptor agonist olodaterol plus the ultra long-acting muscarinic antagonist tiotropium bromide are known to relax equine airways. In human bronchi combining these drugs elicits a positive interaction, thus we aimed to characterize this information further in equine isolated airways stimulated by electrical field stimulation (EFS) and using the Concentration-Reduction Index (CRI) and Combination Index (CI) equations. The drugs were administered alone and together by reproducing ex vivo the concentration-ratio delivered by the currently available fixed-dose combination (1:1)...
March 26, 2018: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29577787/clinical-and-economic-outcomes-associated-with-the-use-of-fluticasone-propionate-250-mcg-and-salmeterol-50-mcg-combination-versus-tiotropium-bromide-18-mcg-as-initial-maintenance-treatment-for-chronic-obstructive-pulmonary-disease-in-managed-care
#10
Christopher F Bell, Anna D Coutinho, Eileen Farrelly, Tasneem Lokhandwala, Pamela Landsman-Blumberg
AIMS: To examine the clinical and economic outcomes associated with the use of long-acting bronchodilators for initial maintenance treatment of chronic obstructive pulmonary disease (COPD) by analyzing health insurance claims data in the United States. METHODS: A retrospective, observational, matched cohort study used health insurance claims data (January 2008 to June 2013) to assess COPD-related outcomes for subjects aged ≥40 years. Subjects were assigned to a study cohort according to the first observed prescription fill for a long-acting bronchodilator (fluticasone propionate 250 mcg/salmeterol 50 mcg [FSC] or tiotropium bromide 18 mcg [TIO])...
March 24, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29551894/factors-influencing-treatment-escalation-from-long-acting-muscarinic-antagonist-monotherapy-to-triple-therapy-in-patients-with-copd-a-retrospective-thin-database-analysis
#11
John R Hurst, Maria Dilleen, Kevin Morris, Siân Hills, Birol Emir, Rupert Jones
Purpose: Inappropriate use of an inhaled corticosteroid (ICS) for COPD has clinical and economic disadvantages. This retrospective analysis of The UK Health Improvement Network (THIN) database identified factors influencing treatment escalation (step-up) from a long-acting muscarinic antagonist (LAMA) to triple therapy (LAMA + long-acting β-agonist-ICS). Secondary objectives included time to step up from first LAMA prescription, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grouping (2011/2013, 2017), and Medical Research Council (MRC) grade prior to treatment escalation...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29497289/seasonal-variations-in-exacerbations-and-deaths-in-patients-with-copd-during-the-tiospir-%C3%A2-trial
#12
Robert A Wise, Peter Ma Calverley, Kerstine Carter, Emmanuelle Clerisme-Beaty, Norbert Metzdorf, Antonio Anzueto
Background: Although COPD exacerbations are known to occur more frequently in winter, there is little information on hospitalizations and cause-specific mortality. This study aimed to examine seasonal variations in mortality and exacerbations in patients with COPD during the TIOtropium Safety and Performance In Respimat® (TIOSPIR® ) trial. Patients and methods: TIOSPIR was a large-scale, multicenter trial, which assessed the safety and efficacy of tiotropium delivered via HandiHaler® (18 μg once daily) or Respimat® Soft Mist™ (2...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29489916/protective-effects-of-tiotropium-alone-or-combined-with-budesonide-against-cadmium-inhalation-induced-acute-neutrophilic-pulmonary-inflammation-in-rats
#13
Shiwei Zhao, Qi Yang, Zhixi Yu, You Lv, Jianming Zhi, Pascal Gustin, Wenhui Zhang
As a potent bronchodilator, the anti-inflammatory effects of tiotropium and its interaction with budesonide against cadmium-induced acute pulmonary inflammation were investigated. Compared to values obtained in rats exposed to cadmium, cytological analysis indicated a significant decrease of total cell and neutrophil counts and protein concentration in bronchoalveolar lavage fluid (BALF) in rats pretreated with tiotropium (70μg/15ml or 350μg/15ml). Zymographic tests showed a decrease of MMP-2 activity in BALF in rats pretreated only with high concentration of tiotropium...
2018: PloS One
https://www.readbyqxmd.com/read/29446377/therapeutic-effects-of-a-long-acting-cholinergic-receptor-blocker-tiotropium-bromide-on-asthma
#14
Li Zhang, Guangyin Huang, Long Jin, Shuhua Han
BACKGROUND The aim of this study was to evaluate the therapeutic effects of tiotropium bromide on asthma. MATERIAL AND METHODS A total of 160 patients with moderate persistent asthma were randomly divided into 4 groups (n=40): the 3 control groups were given fluticasone propionate aerosol (group A), salmeterol-fluticasone propionate inhalant (group B), and tiotropium bromide inhalation powder combined with salmeterol-fluticasone propionate inhalant (group C), respectively, and the experimental group received tiotropium bromide inhalation powder combined with fluticasone propionate aerosol (group D) and salbutamol was used to relieve symptoms when necessary...
February 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29439648/effect-of-12-weeks-of-once-daily-tiotropium-olodaterol-on-exercise-endurance-during-constant-work-rate-cycling-and-endurance-shuttle-walking-in-chronic-obstructive-pulmonary-disease
#15
François Maltais, Denis O'Donnell, Juan Bautista Gáldiz Iturri, Anne-Marie Kirsten, Dave Singh, Alan Hamilton, Kay Tetzlaff, Yihua Zhao, Richard Casaburi
BACKGROUND: The TORRACTO® study evaluated the effects of tiotropium/olodaterol versus placebo on endurance time during constant work-rate cycling and constant speed shuttle walking in patients with chronic obstructive pulmonary disease (COPD) after 12 weeks of treatment. METHODS: The effects of once-daily tiotropium/olodaterol (2.5/5 and 5/5 μg) on endurance time during constant work-rate cycle ergometry (CWRCE) after 6 and 12 weeks of treatment were compared with placebo in patients with COPD in a randomized, double-blind, placebo-controlled, parallel-group clinical trial...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29438808/effect-of-tiotropium-on-spontaneous-expiratory-flow-volume-curves-during-exercise-in-gold-1-2-copd
#16
Janos Porszasz, Nicolò Carraro, Robert Cao, Ashwani Gore, Shuyi Ma, Thomas Jiang, François Maltais, Gary T Ferguson, Denis E O'Donnell, Asif Shaikh, Harry B Rossiter, Richard Casaburi
This substudy of a large, randomized, controlled trial (NCT01072396) examined tiotropium (18 μg qd) effects on dynamic hyperinflation during constant work rate treadmill exercise. Areas-under-the-spontaneous expiratory flow-volume (SEFV)-curves were compared in 20 COPD patients and 16 age-matched untreated controls, using rectangular area ratio (RAR) between peak intrabreath and end-expiratory flow. Seven patients exhibited SEFV curve concavity with RAR ≤ 0.5 (RAR low ) in ≥1 test without tiotropium; (mean ± SD FEV 1 : 1...
February 10, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29427984/controlling-the-risk-domain-in-pediatric-asthma-through-personalized-care
#17
William C Anderson, Stanley J Szefler
Strategies to control the risk domain of NHLBI EPR-3 (National Heart, Lung, and Blood Institute Expert Panel Report-3) asthma guidelines, which includes exacerbations requiring systemic corticosteroids, reduction in lung growth, and progressive loss of lung function, and treatment-related adverse effects, are evolving in children and adolescents. Increasing evidence demonstrates that children and adolescents with asthma are at risk of a reduction in lung growth, leading to lower lung function and potentially chronic obstructive pulmonary disease as adults...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29422778/cost-effectiveness-of-tiotropium-versus-omalizumab-for-uncontrolled-allergic-asthma-in-us
#18
Zafar Zafari, Mohsen Sadatsafavi, J Mark FitzGerald
Background: A significant minority of asthma patients remain uncontrolled despite the use of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA). A number of add-on therapies, including monoclonal antibodies (namely omalizumab) and more recently tiotropium bromide have been recommended for this subgroup of patients. The purpose of this study was to assess the cost-effectiveness of tiotropium versus omalizumab as add-on therapies to ICS + LABA for patients with uncontrolled allergic asthma...
2018: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/29420077/tiotropium-added-to-low-to-medium-dose-inhaled-corticosteroids-ics-versus-low-to-medium-dose-ics-alone-for-adults-with-mild-to-moderate-uncontrolled-persistent-asthma-a-systematic-review-and-meta-analysis
#19
Liqun Wang, Ruirui Zhou, Xiaohui Xie
OBJECTIVE: To assess the efficacy and safety profile of tiotropium when added to low- to medium-dose inhaled corticosteroid (ICS) regimen versus low- to medium-dose ICS alone for adults with mild to moderate uncontrolled persistent asthma. DATA SOURCES: The online databases Pubmed, Embase and the Cochrane Library were searched for relevant data published up to November 14, 2017; we also conducted a supplementary search using clinicaltrials.gov. STUDY SELECTIONS: Only randomized control trials were included in this review...
February 8, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29408386/tiotropium-attenuates-refractory-cough-and-capsaicin-cough-reflex-sensitivity-in-patients-with-asthma
#20
Kensuke Fukumitsu, Yoshihiro Kanemitsu, Takamitsu Asano, Norihisa Takeda, Hiroya Ichikawa, Jennifer Maries Go Yap, Satohi Fukuda, Takehiro Uemura, Osamu Takakuwa, Hirotsugu Ohkubo, Ken Maeno, Yutaka Ito, Tetsuya Oguri, Atsushi Nakamura, Masaya Takemura, Akio Niimi
BACKGROUND: Asthmatic cough is often refractory to standard treatments such as inhaled corticosteroids and long-acting β2 agonists (ICS/LABA). Tiotropium may modulate cough reflex sensitivity of acute viral cough, but its efficacy in asthmatic cough remains unknown. OBJECTIVE: To evaluate whether tiotropium improves cough and cough reflex sensitivity in asthmatic patients refractory to ICS/LABA. METHODS: Seventeen consecutive asthmatic patients with chronic cough despite the use of ICS/LABA [13 females; 43...
February 2, 2018: Journal of Allergy and Clinical Immunology in Practice
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