Efficacy of Tiotropium in Patients with COPD

18 Mar, 14

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Tiotropium is Effective in Indian COPD Patients

Objective

To compare the efficacy of Tiotropium (Tiova; Cipla Ltd., India)) delivered via dry powder inhaler (DPI) versus Tiotropium (Tiova; Cipla Ltd., India) delivered via pressurized metered dose inhaler (pMDI) with a spacer in COPD patients.

Patients and Methods

Randomized, double-blind, double-dummy, crossover study.
20 stable COPD patients aged 40-70 years age with smoking history of 10 pack years or non-smokers with occupational exposure.
Subjects were included and randomized to single doses of Tiotropium (18 mcg) via DPI or via pMDI with anti-static spacer (Zerostat; Cipla Ltd., India) or placebo on three separate days, at least four days apart.

Results

1. Efficacy

The mean maximum change from the baseline for FEV₁ was 384.1 ml with pMDI + spacer, 342.1 ml with DPI and 228 ml with placebo respectively.

Change in mean maximum FEV₁ from the baseline

The mean maximum change from the baseline for FVC was 564.2 ml with pMDI + spacer, 573.2 ml with DPI and 264 ml with placebo respectively.

Change in mean maximum FVC from the baseline

The mean change from the baseline for IC values at different time intervals with pMDI, DPI and placebo are shown below (graph):

Conclusion

The study recommends use of Tiotropium via pMDI with anti-static Cipla spacer in patients who prefer to use and especially in COPD patients especially those who cannot generate sufficient inspiratory flow rates.
Tiotropium administered via pMDI and anti-static Cipla spacer shows a superior time dependent bronchodilator response compared to placebo whereas similar efficacy to Tiotropium administered via DPI.

Respir Med 2007; 101: 2464-2471.

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Related Topics

pressurized metered dose inhaler