Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes

Makoto Yoshida, Takako Nakano, Satoru Fukuyama, Takafumi Matsumoto, Miyuki Eguchi, Atsushi Moriwaki, Shohei Takata, Kentaro Machida, Akiko Kanaya, Koichiro Matsumoto, Yoichi Nakanishi, Hiromasa Inoue

Research output: Contribution to journalArticle

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Abstract

The effects of tiotropium, an inhaled long-acting anti-cholinergic agent, on lung function were investigated in obstructed severe asthmatics with and without emphysematous changes despite maximal recommended treatments with high-dose of inhaled glucocorticoids and inhaled long-acting β2-agonists.We conducted a double-blind, placebo-controlled study of an inhaled single-dose of tiotropium in 18 asthmatics with emphysema and 18 without emphysema in a crossover manner. The primary efficacy outcome was the relative change in forced expiratory volume in 1 s (FEV1) from baseline to 60 min, and the secondary outcome was a relative change in FEV1 from baseline to 12 h. Subsequently, the patients were treated with tiotropium inhaled once daily for 12 weeks in an open label manner, and lung function and symptoms were evaluated.At baseline, patients with or without emphysema had a mean FEV1 of 55.9% before tiotropium and 56.8% before placebo, or 77.4% before tiotropium and 77.6% before placebo of the predicted value and were taking a mean dose of inhaled glucocorticoids of 1444 or 1422 μg/day. Among patients with emphysema, the increase from baseline FEV1 was 12.6 percentage points higher at 60 min after tiotropium than after placebo. Among patients without emphysema, the increase from baseline FEV1 was 5.4 percentage points higher at 60 min after tiotropium than after placebo.Tiotropium resulted in improved lung function and symptoms in asthmatics with and without emphysema. These findings suggest that tiotropium will provide a new strategy for the treatment of bronchial asthma and of overlapping asthma and COPD.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalPulmonary Pharmacology and Therapeutics
Volume26
Issue number2
DOIs
Publication statusPublished - Apr 1 2013

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Emphysema
Lung
Forced Expiratory Volume
Placebos
Glucocorticoids
Asthma
Tiotropium Bromide
Cholinergic Antagonists
Chronic Obstructive Pulmonary Disease
Cholinergic Agents
Labels
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Biochemistry, medical
  • Pharmacology (medical)

Cite this

Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes. / Yoshida, Makoto; Nakano, Takako; Fukuyama, Satoru; Matsumoto, Takafumi; Eguchi, Miyuki; Moriwaki, Atsushi; Takata, Shohei; Machida, Kentaro; Kanaya, Akiko; Matsumoto, Koichiro; Nakanishi, Yoichi; Inoue, Hiromasa.

In: Pulmonary Pharmacology and Therapeutics, Vol. 26, No. 2, 01.04.2013, p. 159-166.

Research output: Contribution to journalArticle

Yoshida, M, Nakano, T, Fukuyama, S, Matsumoto, T, Eguchi, M, Moriwaki, A, Takata, S, Machida, K, Kanaya, A, Matsumoto, K, Nakanishi, Y & Inoue, H 2013, 'Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes', Pulmonary Pharmacology and Therapeutics, vol. 26, no. 2, pp. 159-166. https://doi.org/10.1016/j.pupt.2012.09.007
Yoshida, Makoto ; Nakano, Takako ; Fukuyama, Satoru ; Matsumoto, Takafumi ; Eguchi, Miyuki ; Moriwaki, Atsushi ; Takata, Shohei ; Machida, Kentaro ; Kanaya, Akiko ; Matsumoto, Koichiro ; Nakanishi, Yoichi ; Inoue, Hiromasa. / Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes. In: Pulmonary Pharmacology and Therapeutics. 2013 ; Vol. 26, No. 2. pp. 159-166.
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