Tiotropium Respimat Inhaler and the Risk of Death in COPD

Abstract

Tiotropium Respimat at a dose of 5 μg or 2.5 μg had a safety profile and exacerbation efficacy similar to those of tiotropium HandiHaler at a dose of 18 μg in patients with COPD. (Funded by Boehringer Ingelheim; TIOSPIR ClinicalTrials.gov number, NCT01126437.).

New developments in inhaler devices within pharmaceutical companies: A systematic review of the impact on clinical outcomes and patient preferences

“…Parameters were similar between treatment arms [same molecule: tiotropium; same dosing frequency: once daily (OD)], except for the inhaler device and the Similar results were also found in the Japanese study population [11]. Finally, the safety profile and exacerbation efficacy of tiotropium Respimat ® 5 mg or 2.5 mg OD were found similar to those of tiotropium HandiHaler ® at 18 mg OD in a randomised controlled study (TIOSPIR), in which more than 17.000 patients were enrolled and followed during a period of 2.3 years on average [13].…”

“…The improved therapeutic ratio is probably explained by the low velocity of the aerosol cloud, that enables a high lung deposition and high efficiency of the new device [44]. The prospective TIOSPIR study was specifically set up to compare the long-term safety of tiotropium delivered via Respimat ® vs. HandiHaler ® [13] in a direct way because concerns had arisen from metaanalyses and pharmaco-epidemiological data [45]. In essence, a numerical increase in all-cause mortality had been seen in pooled analyses of registration studies of tiotropium Respimat ® compared to placebo, which was in contrast to the much larger tiotropium HandiHaler ® database.…”

Anticholinergics/Antimuscarinic Drugs in Asthma

“…Tachycardia and atrial fibrillation have been reported and should be used with caution especially among patients with COPD as those patients are older with often-associated comorbidities. However, a recent meta-analysis does not confirm an increased risk of cardiovascular events [43].…”

Possible side effects of drugs in elderly patients with chronic obstructive pulmonary disease and comorbidity

“…Число летальных исходов и тяжелых ССО было сходным во всех 3 группах [30]. Продемонстрировано, что новая форма доставки меньшей дозы тиотропия обладает хорошим профилем безопасности.…”