Comparison of oral bambuterol and terbutaline in elderly patients with chronic reversible airflow obstruction.
Bambuterol, a carbamate prodrug of terbutaline, is the first once-daily oral beta 2-agonist. The effect/side effect ratio of bambuterol oral solution was compared with terbutaline mixture in elderly patients with chronic reversible obstructive airways disease. The study was of a double-blind, crossover, randomized design and consisted of a 4-7-day run-in period followed by four consecutive treatment periods each of 2 weeks. The treatments were bambuterol solution 20 mg nocte (B20), 10 mg nocte (B10), terbutaline mixture 3 mg t.i.d., (T), and placebo solution (P). Patients measured daily peak expiratory flow rate (PEFR), asthma symptoms, use of inhaled beta 2-agonist, and tremor. Of 84 patients, 66 completed all periods. Mean age was 67 years (60-90), basal FEV1 1.49 L, and reversibility of FEV1 30%. Ninety-four percent of the patients used inhaled/oral steroids in constant dosage. All treatments were significantly more effective than placebo. B20 resulted in higher morning PEFR than T (306 +/- 2.9 L/min vs. 297 +/- 2.9 L/min), while B10 gave equivalent results to T. No differences were seen in the use of inhaled beta 2-agonist. Less shortness of breath was experienced during the night with B20 and during the day with B10 compared with placebo. Both B20 and T produced more tremor than B10 and P. In elderly patients with chronic reversible airways obstruction once-daily bambuterol (10-20 mg) has a better effect/side effect ratio than 3 mg terbutaline thrice daily.
McDonald
C F
CF
Austin & Repatriation Medical Centre, Victoria, Australia.
Pierce
R J
RJ
Thompson
P J
PJ
Allen
D
D
Bowler
S
S
Breslin
A B
AB
Bowes
G
G
Saunders
N
N
Murree-Allen
K
K
Frith
P
P
Musk
A W
AW
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013726:Terbutaline / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D003692:Delayed-Action Preparations; D013726:Terbutaline; C047766:bambuterol