Effects of formoterol and tiotropium bromide on mucus clearance in patients with COPD

Meyer, Thomas; Reitmeir, Peter; Brand, Peter; Herpich, C.; Sommerer, Knut; Schulze, Anja; Scheuch, G.; Newman, Stephen P.

doi:10.1016/j.rmed.2011.02.007

Cited by 24 publications

(17 citation statements)

References 24 publications

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“…In one study, 24 patients with mild-to-moderate COPD receiving formoterol were assessed with a radioaerosol technique to determine effects of treatment on mucus clearance. Results indicated that a single dose of formoterol significantly enhanced radioaerosol clearance (71). Treatment with salmeterol also has been shown to increase mucociliary clearance in patients with COPD (72).…”

Section: Impact Of β 2 Adrenoceptor Agonist On Mucociliary Clearancementioning

confidence: 99%

How Do Dual Long-Acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?

Beeh

Burgel

Franssen³

et al. 2017

Am J Respir Crit Care Med

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Word Count: 187 At-a-Glance CommentaryResults from multiple clinical trials have demonstrated that fixed combinations of long-acting β-adrenergic agonists (LABA) and long-acting muscarinic antagonists (LAMA) are significantly superior to their monocomponents and to the combination LABA and an inhaled corticosteroid in decreasing the frequency of exacerbations in patients with chronic obstructive pulmonary disease. At present, the mechanism(s) underlying this clinical benefit are not fully understood.This review considers potential mechanisms whereby LABA/LAMA combinations might exert additive or synergistic effects that lead to a decrease in exacerbations. Mechanisms considered include effects on lung hyperinflation and mechanical stress, inflammation, excessive mucus production with impaired mucociliary clearance, and symptom severity and variability. Word count: 188

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Section: Impact Of β 2 Adrenoceptor Agonist On Mucociliary Clearancementioning

confidence: 99%

How Do Dual Long-Acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?

Beeh

Burgel

Franssen³

et al. 2017

Am J Respir Crit Care Med

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“…significantly enhanced mucus clearance compared with tiotropium 18 μg q.d. in patients with mild-to-moderate COPD [59]. AUGMENT demonstrated that treatment with both formoterol 12 μg b.i.d.…”

Section: Efficacy Of Bronchodilators In Prevention Of Exacerbationsmentioning

confidence: 99%

Optimizing bronchodilation in the prevention of COPD exacerbations

2017

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The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments. The latter recommendation is based on recent trial evidence demonstrating the superior efficacy of a fixed-dose LABA/LAMA over an inhaled corticosteroid (ICS)/LABA in exacerbation prevention. ICS in combination with a LABA is also indicated for prevention of exacerbations, but the use of ICS is associated with an increased risk of adverse events such as pneumonia, and offers limited benefits beyond those provided by LABA or LAMA monotherapy. In this review, we examine evidence from a number of pivotal studies of LABAs and LAMAs, administered as monotherapy or as part of dual or triple combination therapy, with a specific focus on their effect on exacerbations. We also discuss a new proposed treatment paradigm for the management of COPD that takes into account this recent evidence and adopts a more cautious approach to the use of ICS. In alignment with GOLD 2017, we suggest that ICS should be reserved for patients with concomitant asthma or in whom exacerbations persist despite treatment with LABA/LAMA.

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“…The ciliary beat frequency was shown to be significantly reduced in nasal epithelium samples from subjects with COPD and subjects with pneumonia compared to healthy subjects while salmeterol applied ex vivo in these samples increased ciliary beat frequency in concentration-dependent manner in all subjects [31]. Recently, single inhaled dose of formoterol (12 μg) was shown to enhance mucus clearance in mild/ moderate COPD patients compared to placebo and tiotropium (18 μg) or salbutamol (200 μg) [32]. Furthermore, in that study treatment for 14 days with tiotropium retarded mucus clearance while this was not observed with formoterol suggesting that formoterol sustains its mucociliary effect during 14 days treatment.…”

Section: Mucociliary Clearancementioning

confidence: 99%

Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol

Santus

Radovanovic

Paggiaro

et al. 2015

European Journal of Internal Medicine

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Effects of formoterol and tiotropium bromide on mucus clearance in patients with COPD

Cited by 24 publications

References 24 publications

How Do Dual Long-Acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?

How Do Dual Long-Acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?

Optimizing bronchodilation in the prevention of COPD exacerbations

Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol

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