title: [The effect of inhaled anticholinergic drugs (tiotropium bromide) on asthma patients with persistent obstructive ventilatory impairment].
abstract: OBJECTIVE
  This study investigated the effects of tiotropium bromide on chronic asthma patients with persistent obstructive ventilatory impairment (FEV1/FVC%<70%) like COPD.
  
  
  METHODS
  Twenty-four patients (14 males, 10 females, mean age 64.3±10.7 years old) were enrolled. They were all treated with a high dose inhaled steroids and a long-acting β2-agonist. All patients had bronchial reversibility, normal diffusing capacity (DLCO) and no low attenuation areas in HRCT. This study examined the FEV1 at baseline and after inhalation of short-acting bronchodilators (400 μg salbutamol and 40 μg ipratropium, 15 minutes and 30 minutes after, respectively). Eleven patients agreed to take an additional treatment with tiotropium, and received 18 μg of tiotropium per daily for one year. The usual treatments were continued for 7 patients that did not agree to take tiotropium and for 6 patients who were ineligible for tiotropium due to co-morbidities. The FVC, FEV1, FEV1/FVC%, V50, and IC were compared between the two groups after one year.
  
  
  RESULTS
  FEV1 and V50 were significantly elevated after one year in the tiotropium-treated patients in comparison to those in the 13 subjects that did not receive tiotropium bromide, after adjusting for age, smoking and the values determined on enrollment. There was a positive correlation between the change of FEV1 30 min after ipratropium inhalation (short-term effect) and FEV1 one year after tiotropium inhalation (long-term effect).
  
  
  CONCLUSIONS
  Combination treatment with tiotropium, high dose steroids and long-acting β2 agonist inhalation provides improvement in the expiratory flow limitations of asthma patients with persistent obstructive ventilatory impairment.
authors: Department of Respiratory Medicine, Fukuoka National Hospital, Japan.
authors: Hiroko
authors: H
authors: Nogami
authors: Satoshi
authors: S
authors: Honjo
authors: Tomoaki
authors: T
authors: Iwanaga
mesh_terms: D000280:Administration, Inhalation; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000209:etiology; D012120:Respiration Disorders / Q000188:drug therapy / Q000209:etiology*; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D013256:Steroids / Q000008:administration & dosage; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D012602:Scopolamine Derivatives; D013256:Steroids; D009241:Ipratropium; D000069447:Tiotropium Bromide