title: Effects of tiotropium on lung function in current smokers and never smokers with bronchial asthma.
abstract: The effects of tiotropium, an inhaled long-acting muscarinic antagonist, on lung function were investigated in current smokers and nonsmokers with asthma treated with inhaled corticosteroids (ICSs) and other asthma controllers: inhaled long-acting β2agonists, leukotriene receptor antagonists, and/or theophylline. We conducted a double-blind, placebo-controlled study of an inhaled single dose of tiotropium in 9 asthmatics currently smoking and 9 asthmatics who have never smoked in a crossover manner. Lung function was measured before and 1, 3, and 24 h after inhalation of 18 μg of tiotropium or a placebo. The primary outcome was a change in forced expiratory volume in 1 s (FEV1) from the baseline, and the secondary outcomes were changes in peak expiratory flow rate (PEFR), V˙50, and V˙25. At baseline, asthmatics with and without a smoking history had a mean FEV1of 2590 ml and 2220 ml and were taking a mean dose of ICSs of 1208 and 1000 μg/day, respectively. The increase from the baseline FEV1was 169 ml and 105 ml higher at 3 h after tiotropium than after the placebo in current smokers and nonsmokers, respectively. PEFR, V˙50, and V˙25were also significantly increased after tiotropium as compared with the placebo in both study groups. Changes in FEV1and PEFR tended to be greater in asthmatics currently smoking than in subjects who have never smoked, although there were no statistical differences at any time points. Tiotropium resulted in improved lung function and symptoms both in current smoker and nonsmoker asthmatics. These findings suggest that tiotropium will provide a new strategy for the treatment of bronchial asthma.
authors.affiliation: Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan. Electronic address: myoshida@mfukuoka2.hosp.go.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan; Division of Respiratory Medicine, Nishi-Fukuoka Hospital, 3-18-8 Ikinomatsubara, Nishi-ku, Fukuoka 819-8555, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kaneko
authors.affiliation: Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishimatsu
authors.affiliation: Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Komori
authors.affiliation: Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Iwanaga
authors.affiliation: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010366:Peak Expiratory Flow Rate; D012907:Smoking / Q000453:epidemiology*; D013997:Time Factors; D000069447:Tiotropium Bromide / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D018727:Muscarinic Antagonists; D000069447:Tiotropium Bromide
keywords: Bronchial asthma; Current smoker; Tiotropium