[Theoretical and clinical aspects of tiotropium application as a first line therapy in stable state of all stages of chronic obstructive pulmonary disease].
Current guidelines ERS, ATS, GOLD recommend use of one or more inhaler long-acting bronchodilators to alleviate symptoms and reduce risk of exacerbations for the symptomatic patients with moderate to severe in stabile COPD. Since parasympathetic activity is the dominant reversible component of airway obstruction in COPD, anticholinergic agent became first-line treatment. Exacerbations of COPD are associated with progression of disease. Clinical trials have confirmed that tiotropium is superior to salmeterol in preventing COPD exacerbations in patients with moderate to very severe COPD with history of exacerbations. Tiotropium also resulted in a significant reduction in the decline in post-bronchodilator FEV1, suggesting possible disease modification in younger patients with COPD. The safety data review does not indicate an increased risk for death or cardiovascular morbidity during tiotropium treatment in patients with COPD. Tiotropium was associated with a reduction in the risk of all-cause mortality.
Warszawski Uniwersytet Medyczny, Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii.
Ryszarda
R
Chazan
D018680:Cholinergic Antagonists / Q000627:therapeutic use; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012602:Scopolamine Derivatives / Q000627:therapeutic use*; D000069447:Tiotropium Bromide
D018680:Cholinergic Antagonists; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide