Tiotropium: a bronchodilator for chronic obstructive pulmonary disease.
OBJECTIVE
To review the scientific literature evaluating the efficacy and tolerability of tiotropium bromide, a new bronchodilator indicated for treatment of chronic obstructive pulmonary disease (COPD).


METHODS
Articles were identified through searches of MEDLINE (1966-January 2005) using the key words tiotropium, BA 679 BR, chronic obstructive pulmonary disease, and anticholinergic agents. Additional citations were identified from bibliographies of publications cited.


METHODS
Experimental and observational studies of tiotropium bromide were selected. Trials of the efficacy of the drug in humans were the focus of the review.


RESULTS
Tiotropium bromide is an effective bronchodilator for patients with COPD. It produces clinically important improvements in lung function, symptoms of dyspnea, quality of life, and exacerbation rates compared with placebo. In comparative studies, tiotropium does not appear to be more efficacious than salmeterol or ipratropium.


CONCLUSIONS
Tiotropium is an effective inhaled anticholinergic agent that is recommended among preferred long-acting bronchodilators for the chronic management of moderate to very severe COPD. Although similar to ipratropium in efficacy and tolerability, it has the advantage of once-daily dosing.
Somand
Heather
H
College of Pharmacy, University of Michigan, Ann Arbor, MI 48109-0008, USA.
Remington
Tami L
TL
D000420:Albuterol / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D015444:Exercise; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012602:Scopolamine Derivatives / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000069447:Tiotropium Bromide
D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D012602:Scopolamine Derivatives; D000420:Albuterol; D000069447:Tiotropium Bromide