Top

Drugs

Published in:

01-06-2002 | Adis New Drug Profile

Tiotropium Bromide

Authors: Karen M. Hvizdos, Karen L. Goa

Published in: Drugs | Issue 8/2002

Abstract

▴ Tiotropium bromide is an anticholinergic bronchodilator that antagonises muscarinic M₁, M₂ and M₃ receptors. It dissociates more slowly from M₁ receptors and, importantly, from M₃ receptors (which are located in bronchial smooth muscle) than from M₂ receptors and subsequently has a long duration of action permitting once-daily administration.
▴ In patients with chronic obstructive pulmonary disease (COPD), tiotropium 18μg once daily significantly improved lung function compared with placebo and ipratropium 40μg four times daily in 1-year trials or salmeterol 50μg twice daily in a 6-month study.
▴ The incidence of COPD exacerbations decreased and use of rescue medication was lower with tiotropium compared with placebo or ipratropium. There was no evidence of tachyphylaxis during 1-year treatment with tiotropium.
▴ Compared with placebo, salmeterol and ipratropium, tiotropium produced significant improvements in patients’ perception of dyspnoea and health-related quality of life.
▴ Tiotropium is generally well tolerated; dry mouth is the most common drug-related adverse event, occurring in about 10 to 16% of patients in clinical trials.

The COPD Guidelines Group of the Standards of Care Committee of the BTS. BTS guidelines for the management of chronic obstructive pulmonary disease. Thorax 1997 Dec; 52 Suppl. 5: S1–S28

American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 152: S77–120

Pauwels RA, Buist AS, Calverley PMA, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global initiative for chronic Obstructive Lung Disease (GOLD) workshop summary. Am J Respir Crit Care Med 2001; 163: 1256–76PubMed

Eglen RM, Hegde SS, Watson N. Muscarinic receptor subtypes and smooth muscle function. Pharmacol Rev 1996; 48(4): 531–65PubMed

Haddad E-B, Mak JCW, Barnes PJ. Characterization of [3H]Ba 679 BR, a slowly dissociating muscarinic antagonist, in human lung: radioligand binding and autoradiographic mapping. Mol Pharmacol 1994 May; 45: 899–907PubMed

Disse B, Reichl R, Speck G, et al. Ba 679 BR, a novel long-acting anticholinergic bronchodilator. Life Sci 1993; 52: 537–44PubMedCrossRef

Takahashi T, Belvisi MG, Patel H, et al. Effect of Ba 679 BR, a novel long-acting anticholinergic agent, on cholinergic neurotransmission in guinea pig and human airways. Am J Respir Crit Care Med 1994 Dec; 150 (6 Pt 1): 1640–5PubMed

Maesen FPV, Smeets JJ, Sledsens TJH, et al. Tiotropium bromide, a new long-acting antimuscarinic bronchodilator: a pharmacodynamic study in patients with chronic obstructive pulmonary disease (COPD). Eur Respir J 1995; 8: 1506–13PubMed

Calverley PMA, Towse LJ, Lee A. The timing of dose and pattern of bronchodilatation of tiotropium (TIO) in stable COPD [abstract no. P523]. Eur Respir J 2000; 16 Suppl. 31: 56s

10.

Hasani A, Agnew JE, Dilworth JP, et al. Effect of tiotropium on distribution pattern of aerosol particles deposited in the lung [abstract no. A98]. Am J Respir Crit Care Med 2001 Apr; 163 Suppl. Pt 2: A277

11.

Hasani A, Agnew JE, Dilworth JP, et al. Effect of tiotropium on lung ventilatory distribution in COPD patients [abstract]. Am J Respir Crit Care Med 2001 Apr; 163 Suppl. Pt 2: 282

12.

McNicholas WT, Calverley PMA, Edwards C, et al. Effects of anticholinergic therapy (tiotropium) on REM-related desaturation (SaO2) and sleep quality in patients with COPD [abstract]. Am J Respir Crit Care Med 2001 Apr; 163 Suppl. Pt 2: 280

13.

Disse B, Speck GA, Rominger KL, et al. Tiotropium (Spiriva): mechanistical considerations and clinical profile in obstructive lung disease. Life Sci 1999; 64: 457–64PubMedCrossRef

14.

Disse B, Rominger K, Serby CW, et al. The pharmacokinetic (PK) profile of tiotropium during long-term treatment in stable COPD [abstract]. Am J Respir Crit Care Med 1999 Mar; 159 Suppl. Pt 2: A524

15.

Vincken W, van Noord JA, Greefhorst APM, et al. Improved health outcomes in patients with COPD during 1 yr’s treatment with tiotropium. Eur Respir J 2002 Feb; 19(2): 200–16CrossRef

16.

Littner MR, Ilowite JS, Tashkin DP, et al. Long-acting bronchodilation with once-daily dosing of tiotropium (Spiriva) in stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000 Apr; 161: 1136–42PubMed

17.

Casaburi R, Mahler DA, Jones PW, et al. A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease. Eur Respir J 2002 Feb; 19(2): 217–24PubMedCrossRef

18.

Donohue JF, van Noord JA, Bateman ED, et al. A 6-month placebo-controlled study comparing lung function and health status changes in COPD patients treated with tiotropium or salmeterol. Chest. In press

19.

San Pedro G, Elias DJ, Serby CW, et al. Tiotropium (Spiriva): one year bronchodilator efficacy established with once daily dosing in COPD patients [abstract]. Am J Respir Crit Care Med 2000 Mar; 161 Suppl. Part 2: 749

20.

Zu Wallack R, Jones PW, Kotch A, et al. Tiotropium (Spiriva) improves health status in patients with COPD [abstract]. Am J Respir Crit Care Med 2000 Mar; 161 Suppl. Part 2: 892

21.

Mahler DA, Montner P, Brazinsky SA, et al. Tiotropium (Spiriva), a new long-acting anticholinergic bronchodilator, improves dyspnea in patients with COPD [abstract]. Am J Respir Crit Care Med 2000 Mar; 161 Suppl. Part 2: 892

22.

Casaburi R, Briggs Jr DD, Donohue JF, et al. The spirometric efficacy of once-daily dosing with tiotropium in stable COPD. Chest 2000; 118: 1294–302PubMedCrossRef

23.

Wanner A, ZuWallack R, Elias D, et al. Efficacy of once daily tiotropium (TIO) in stable COPD [abstract no. P3406]. Eur Respir Soc 1999 Oct 9

24.

van Noord JA, Bantje TA, Eland ME, et al. A randomised controlled comparison of tiotropium nd ipratropium in the treatment of chronic obstructive pulmonary disease. Dutch Tiotropium Study Group. Thorax 2000 Apr; 55: 289–94PubMedCrossRef

25.

Vincken W, Greefhorst APM, Westbroek J, et al. Once-daily tiotropium (TIO) is more efficacious than q.i.d. ipratropium (IB) as maintenance treatment of COPD [abstract no. P3407]. Eur Respir Soc 1999 Oct 9

26.

Vincken WG, Vermiere P, Menjoge SS, et al. Maintenance of bronchodilation following tiotropium in patients with mild, moderate and severe COPD in one year clinical trials [abstract no. P2202]. Eur Respir J Suppl 2001 Sep; 18 Suppl. 33: 331s

27.

Kesten S, Flanders J, Menjoge SS, et al. Improvements in COPD following treatment with tiotropium in elderly patients [abstract]. Am J Respir Crit Care Med 2001 Apr; 163 (5) Suppl. Pt 2

28.

Weisman I, Menjoge SS, Serby CW, et al. Influence of gender on outcomes in large COPD clinical trials [abstract]. Am J Respir Crit Care Med 2001 Apr; 163(5) Suppl. Pt 2: A281

29.

Vincken W, van Noord JA, Greefhorst APM, et al. Superior bronchodilator effects of tiotropium (TIO) vs. ipratropium (IB) in COPD over a one year clinical trial [abstract no. P516]. Eur Respir J 2000; 16 Suppl. 31: 55s

30.

Kesten S, Flanders J, Serby CW, et al. Compliance with tiotropium, a once daily dry powder inhaled bronchodilator, in one year COPD trials. Chest 2000 Oct; 118 Suppl.: 191S–2S

31.

Chodosh S, Flanders J, Serby CW, et al. Effective use of HandiHaler dry powder inhalation system over a range of COPD disease severity [abstract]. Am J Respir Crit Care Med 1999; 159 Suppl: A524

32.

Jones PW, Quirk FH, Baveystock CM, et al. A self-complete measure of health status for chronic airflow limitation. The St. George’s Respiratory Questionnaire. Am Rev Respir Dis 1992; 145: 1321–7PubMed

Title: Tiotropium Bromide
Authors: Karen M. Hvizdos
Karen L. Goa
Publication date: 01-06-2002
Publisher: Springer International Publishing
Published in: Drugs / Issue 8/2002
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200262080-00008

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tiotropium Bromide

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2002

Tiotropium Bromide

Tiotropium Bromide

Candesartan Cilexetil

Pegfilgrastim

Sickle Cell Anaemia

Management of Cutaneous Erythrasma