The effect of inhaled tiotropium bromide on lung mucociliary clearance in patients with COPD.
OBJECTIVE
To assess the effects of tiotropium on lung mucociliary clearance in COPD.


METHODS
Randomized, double-blind, placebo-controlled, parallel-group study.


METHODS
Outpatients of an urban-area university teaching hospital.


METHODS
Thirty-four patients with COPD aged 40 to 75 years classified equally into two groups.


METHODS
Single (18 microg) daily dose of tiotropium inhalation capsules or of placebo for 21 days.


METHODS
Six-hour tracheobronchial clearance of inhaled 99mTc-labeled polystyrene particles using a 48-h retention measurement to determine the "nontracheobronchial" deposition fraction.


RESULTS
Test radioaerosol penetration into the lungs increased significantly (p < 0.003) as did FEV1 (p < 0.006) in the tiotropium-treated patients, but measured mucociliary clearance was not significantly changed despite the increased pathway length for clearance (mean +/- SE area under the tracheobronchial retention curve changed from 442 +/- 22 to 453 +/- 20%/h). Smaller (nonsignificant) decreases of radioaerosol penetration and FEV1 occurred in the placebo group together with a small (nonsignificant) decrease in the area under the retention curve.


CONCLUSIONS
Twenty-one days of inhaled tiotropium, 18 microg/d, as a dry powder does not retard mucus clearance from the lungs.
Hasani
Amir
A
Department of Medical Physics, Royal Free Hampstead NHS Trust and Royal Free and University College Medical School, London, UK. amer.alhasani@royalfree.nhs.uk
Toms
Nathan
N
Agnew
John E
JE
Sarno
Maria
M
Harrison
Aleck J
AJ
Dilworth
Paul
P
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000187:drug effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D012602:Scopolamine Derivatives / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000069447:Tiotropium Bromide
D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide