title: Improvement of pulmonary function and dyspnea by tiotropium in COPD patients using a transdermal beta(2)-agonist.
abstract: BACKGROUND
  A combination of bronchodilators may be effective in the treatment of chronic obstructive pulmonary disease (COPD). We examined the effect of adding a long-acting anti-cholinergic agent (tiotropium) to a transdermal-type beta(2)-agonist (tulobuterol) on dyspnea as well as pulmonary function.
  
  
  METHODS
  In a multicentre, randomized, parallel design study, 60 COPD patients treated with the transdermal beta(2)-agonist tulobuterol were divided into a tiotropium added group (Tulo+Tio group, n=40) or transdermal beta(2)-agonist tulobuterol alone group (Tulo group, n=20), and then treated for 4 weeks after a 2 week run-in period. Pulmonary function and a dyspnea (Medical Research Council (MRC)) scale were assessed before and after the treatment. Daily peak expiratory flow (PEF) monitoring was also performed.
  
  
  RESULTS
  After 4 weeks, the Tulo+Tio group showed a significant increase in pulmonary function compared with the Tulo group; DeltaFVC (0.31+/-0.06 L vs. 0.06+/-0.05 L, p< 0.01), DeltaFEV(1) (0.15+/-0.03 L vs. -0.02+/-0.02 L, p<0.0001), and DeltaPEF (41.0+/-5.1 L/min vs. 0.5+/-3.5 L/min, p<0.0001). The MRC dyspnea scale was also significantly improved in Tulo+Tio, but not in Tulo group.
  
  
  CONCLUSIONS
  These results suggest that tiotropium caused a significant improvement in both pulmonary function and dyspnea in COPD patients already treated with the transdermal beta(2)-agonist tulobuterol.
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Akamatsu
authors.forename: T
authors.initials: T
authors.lastname: Yamagata
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Miura
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: Y
authors.initials: Y
authors.lastname: Yamagata
authors.forename: T
authors.initials: T
authors.lastname: Ichikawa
authors.forename: S
authors.initials: S
authors.lastname: Yanagisawa
authors.forename: K
authors.initials: K
authors.lastname: Ueshima
authors.forename: T
authors.initials: T
authors.lastname: Hirano
authors.forename: M
authors.initials: M
authors.lastname: Nakanishi
authors.forename: K
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Y
authors.initials: Y
authors.lastname: Minakata
authors.forename: M
authors.initials: M
authors.lastname: Ichinose
mesh_terms: D000279:Administration, Cutaneous; D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004357:Drug Synergism; D004417:Dyspnea / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012602:Scopolamine Derivatives / Q000008:administration & dosage / Q000627:therapeutic use*; D013726:Terbutaline / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069447:Tiotropium Bromide
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; C010809:tulobuterol; D013726:Terbutaline; D000069447:Tiotropium Bromide