The aim of this study was to compare the effects of formoterol, ipratropium bromide and a placebo on walking distance, lung function, symptoms and quality of life (QoL) in chronic obstructive pulmonary disease (COPD) patients.A total of 183 patients (mean age 64 yrs, 86 female) with moderate-to-severe nonreversible COPD participated in this randomised, double-blind, parallel-group study. After a 2-week placebo run-in, patients were randomised to formoterol Turbuhaler1 18 mg b.i.d. (delivered dose), ipratropium bromide 80 mg t.i.d. via a pressurised metered dose inhaler, or placebo for 12 weeks. Inhaled short-acting b 2 -agonists were allowed as relief medication and inhaled glucocorticosteroids were allowed at a constant dose. The primary variable was walking distance in the shuttle walking test (SWT). Baseline mean SWT distance was 325 m, mean forced expiratory volume in one second (FEV1) was 40% predicted.Clinically significant improvements in SWT (w30 m) were seen in 41, 38 and 30% of formoterol, ipratropium and placebo patients, respectively (not significant). Mean increases from run-in were 19, 17 and 5 m in the formoterol, ipratropium and placebo groups, respectively. Both active treatments significantly improved FEV1, forced vital capacity, peak expiratory flow and daytime dyspnoea score compared with placebo. Formoterol reduced relief medication use compared with placebo. Neither active treatment improved QoL.Formoterol and ipratropium improved airway function and symptoms, without significant improvements in the shuttle walking test. Eur Respir J 2002; 20: 1138- Chronic obstructive pulmonary disease (COPD) is characterised by slowly developing airway obstruction, with increasing impairment of exercise performance due to dyspnoea. The pharmacological therapy of COPD is mainly focused on the use of bronchodilators such as anticholinergics and b 2 -agonists, and the role of inhaled glucocorticosteroids (GCS) is currently being discussed [1][2][3][4][5]. The goal of treatment is to improve exercise capacity, lung function and arterial blood gas tensions, and to reduce the symptoms of dyspnoea. However, studies have shown, that the effects of bronchodilators on these different outcome variables are not always well correlated [6,7].Long-acting bronchodilators are effective in the treatment of asthma, reducing symptoms and decreasing exacerbations [8]. In COPD, the long-acting b 2 -agonists are less well studied. One study of salmeterol showed symptom reduction and lung function improvement [9] and some improvement in quality of life (QoL) when the drug was used in low doses [10]. Formoterol is a b 2 -agonist with a long-acting bronchodilating effect in asthma lasting 12 h but unlike salmeterol, it has an onset of action as fast as salbutamol [11]. However, formoterol has been subject to few long-term studies in COPD. Ipratropium bromide has an established position in the treatment of COPD and has been suggested as the first choice of treatment for this condition [1,3].Exercise capacity of patients w...
We evaluated the efficacy of once‐daily versus twice‐daily treatment with budesonide, delivered by a Turbuhaler®, in the management of children with stable asthma in a randomized, double‐blind, parallel‐group study involving 206 children (age 5–15 years). After a 2‐week run‐in period during which the children were maintained on their usual dose of budesonide (200 μg or 400 μg/day), patients were randomized to receive the same daily dose in either two daily administrations (morning and evening) or as a single dose in the morning over a period of 12 weeks. The primary efficacy variable was morning peak expiratory flow (PEF). The mean morning PEF during the run‐in phase was 271 L/min in patients randomized to once‐daily treatment and 264 L/min in those randomized to twice‐daily treatment. The mean change from baseline to the last 2 weeks of the treatment period in the two groups was −0.3 L/min (95% confidence limits −6.6 to +6.0) and 2.5 L/min (−4.3 to +9.3). The estimated difference between the groups was −2.8 L/min, with 90% confidence limits of −10.4 + 4.5; these were close to the limits regarded as indicative of equivalence (−10 to +10), and hence the difference was not regarded as clinically relevant. Similarly, there were no significant differences between the groups in regard to secondary efficacy measures such as spirometric tests and symptom scores. Both treatments were well tolerated. We conclude that once‐daily administration of budesonide by Turbuhaler® is as effective as twice‐daily treatment in the management of stable asthma in children treated with inhaled steroids at doses of 200–400 μg/day. Pediatr Pulmonol. 1999; 28:337–343. © 1999 Wiley‐Liss, Inc.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.