Improvement in Exercise Tolerance With the Combination of Tiotropium and Pulmonary Rehabilitation in Patients With COPD

Casaburi, Richard; Kukafka, David S.; Cooper, Christopher B.; Witek, Theodore J.; Kesten, Steven

doi:10.1378/chest.127.3.809

Cited by 341 publications

(223 citation statements)

References 23 publications

Supporting

Mentioning

197

Contrasting

Unclassified

Order By: Relevance

“…The elastic properties of the lungs are responsible for resistance and potential collapse of peripheral airways. Residual volume (RV) is typically increased at rest in COPD patients and additionally dynamic hyperinflation occurs during physical activities, which is associated with increased expiratory effort 13,14 . Systemic consequences are often found in cardiovascular, musculoskeletal and other systems [15][16][17][18] .…”

Section: Definition and Pathophysiologymentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

Koblížek

Chlumský²,

Zindr³

et al. 2013

BIOMED PAP

125

116

View full text Add to dashboard Cite

Section: Definition and Pathophysiologymentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

Koblížek

Chlumský²,

Zindr³

et al. 2013

BIOMED PAP

125

116

View full text Add to dashboard Cite

“…75-80% peak work-rate) have been used to demonstrate the positive effects of interventions such as bronchodilator therapy [252,253,262]; oxygen [263] and heliox [254] administration during exercise; bronchoscopic lung volume reduction [264]; and rehabilitation [265,266]. By using this approach, it is possible to demonstrate a significant improvement in endurance time, mostly due to a reduction in lung dynamic hyperinflation and dyspnoea at isotime (table 3).…”

Section: Symptom-limited Incremental Testmentioning

confidence: 99%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

European Respiratory Journal

549

390

View full text Add to dashboard Cite

Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

show abstract

“…Although Study #205.230 18 had a 24-week observation period, it was decided not to include this study in the pooled analysis as patients underwent pulmonary rehabilitation alongside tiotropium or placebo treatment. However, to ensure that the addition of this study did not alter the conclusions, analyses were repeated after inclusion of this study.…”

Section: Planned Analysesmentioning

confidence: 99%

Patient-level pooled analysis of the effect of tiotropium on COPD exacerbations and related hospitalisations

Halpin

Menjoge

Viel

2009

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Aim: To assess the effect of tiotropium 18mcg once daily on chronic obstructive pulmonary disease (COPD) exacerbations and exacerbation-related hospitalisations using a patient-level pooled analysis.Methods: All completed randomised, placebo-controlled, parallel-group tiotropium trials with a duration of >24 weeks were included (n=9). An exacerbation was defined in each study as >2 respiratory symptoms lasting >3 days, and requiring treatment with antibiotics and/or systemic steroids and/or hospitalisation.Results: Compared with placebo (2,862 patients), tiotropium (3,309 patients) significantly reduced by 21% both the risk of COPD exacerbation (95% confidence interval [CI] 0.73-0.86; p<0.0001) and the risk of exacerbation-associated hospitalisation (95% CI 0.65-0.96; p=0.015). Time to first exacerbation and first associated hospitalisation were increased. The protective effect of tiotropium was consistent regardless of age, gender, inhaled corticosteroid use and disease severity. Conclusion:This analysis provides further confirmatory evidence that tiotropium reduces the risk of exacerbation and associated hospitalisation.

show abstract

Improvement in Exercise Tolerance With the Combination of Tiotropium and Pulmonary Rehabilitation in Patients With COPD

Cited by 341 publications

References 23 publications

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

Recommendations on the use of exercise testing in clinical practice

Patient-level pooled analysis of the effect of tiotropium on COPD exacerbations and related hospitalisations

Contact Info

Product

Resources

About