Combination of formoterol and tiotropium in the treatment of COPD: effects on lung function.
Bronchodilators are central in symptomatic management of all stages of COPD. For patients whose COPD is not sufficiently controlled by monotherapy, combining an inhaled anticholinergic and a ss(2)-agonist is a convenient way of delivering treatment and obtaining better lung function and improved symptoms. Formoterol (beta(2)-agonist) and tiotropium (anticholinergic) are long-acting bronchodilators with different mechanisms of action. Formoterol has a fast onset and a bronchodilator effect of approximately 12 h, while tiotropium has a 24-h bronchodilator effect and is given once daily. Currently, there is no documentation that tiotropium is superior to formoterol or the contrary, but a combination of tiotropium and formoterol is more effective than single drugs alone in inducing bronchodilation and a bronchodilator-mediated symptom benefit in patients suffering from COPD. Once-daily or twice-daily formoterol, added to tiotropium, are both better than tiotropium alone, but the published evidence suggests twice-daily formoterol is the best add-on option.
Division of Respiratory Diseases, Department of Internal Medicine, University of Rome Tor Vergata, Rome, Italy. mario.cazzola@uniroma2.it
Mario
M
Cazzola
Donald P
DP
Tashkin
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000818:Animals; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000627:therapeutic use*; D005541:Forced Expiratory Volume / Q000187:drug effects* / Q000502:physiology; D000068759:Formoterol Fumarate; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012602:Scopolamine Derivatives / Q000627:therapeutic use*; D000069447:Tiotropium Bromide; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects* / Q000502:physiology
D000318:Adrenergic beta-Agonists; D018680:Cholinergic Antagonists; D004983:Ethanolamines; D012602:Scopolamine Derivatives; D000068759:Formoterol Fumarate; D000069447:Tiotropium Bromide