Effect of add-on therapy of tiotropium in COPD treated with theophylline.
BACKGROUND
Although combination therapy with bronchodilators is recommended for chronic obstructive pulmonary disease (COPD), there is insufficient evidence for the efficacy of some combinations of long-acting bronchodilators.


OBJECTIVE
We investigated the effects of a combination therapy with tiotropium and theophylline in COPD patients.


METHODS
In a 12-week, open-labeled, parallel-group randomized study, pulmonary functions and dyspnea scores were compared between the combination and theophylline alone therapy at baseline, and 4 and 8 weeks after randomization in COPD.


RESULTS
Sixty-one COPD patients completed the trial (31 combination therapy, 30 theophylline alone; mean age 70 years; 58 males; mean dyspnea score 2.0 and forced expiratory volume in one second (FEV1) 1.5 L [62.5% predicted]). FEV1 in the combination group, but not in the theophylline alone, was significantly increased at 4 (1.56 +/- 0.13 L, p < 0.001) and 8 weeks (1.60 +/- 0.13 L, p < 0.001) from the baseline (1.40 +/- 0.12 L). In the combination group, but not the theophylline alone group, the dyspnea score was significantly improved after 4 (p < 0.01) and 8 weeks (p <0.05) compared with baseline. In 17 patients who did not receive theophylline at screening, treatment with 4 or 8 weeks of theophylline alone did not improve dyspnea score or FEV1.


CONCLUSIONS
Addition of tiotropium therapy to theophylline treatment can improve dyspnea and pulmonary function in COPD. Although this study did not assess whether there was any benefit of adding theophylline to patients treated with tiotropium, tiotropium can be a useful addition in COPD already treated with theophylline.
Kawayama
Tomotaka
T
Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
Hoshino
Tomoaki
T
Ichiki
Masao
M
Tsuda
Toru
T
Kinoshita
Masaharu
M
Takata
Shohei
S
Koga
Takeharu
T
Iwanaga
Tomoaki
T
Aizawa
Hisamichi
H
D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004417:Dyspnea / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D013806:Theophylline / Q000008:administration & dosage*; D000069447:Tiotropium Bromide; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D013806:Theophylline; D000069447:Tiotropium Bromide