Bronchodilators form the main stay of treatment for COPD. When symptoms are not adequately controlled with one bronchodilator, addition of another bronchodilator is recommended. The authors have recently developed a combination of tiotropium and formoterol in a single pressurized metered dose inhaler (pMDI).

The aim of this study was to compare the bronchodilator effects of a single dose of 18mcg of tiotropium versus a single dose of a combination of 18mcg tiotropium plus 12mcg formoterol administered via a pMDI in subjects with moderate–to–severe COPD. A combination of tiotropium plus formoterol administered via a single inhaler produced a superior bronchodilator response than tiotropium alone over a period of 24h.

Methods

• 44 COPD subjects were enrolled in this randomized, double-blind, multi-centre, cross-over study.
• 18mcg tiotropium and 18mcg tiotropium plus 12mcg formoterol were administered via pressurized metered dose inhalers on two separate days.
• FEV₁, FVC and Inspiratory capacity (IC) were measured before, 15, 30min, 1, 2, 3, 4, 6, 8, 12 and 24h after the study drugs were administered.

Results

• Compared with tiotropium alone, a combination of tiotropium plus formoterol showed a faster onset of bronchodilator response (p<0.01 for FEV₁ and FVC), a greater mean maximum change in FEV₁ (p=0.01) and FVC (p=0.008) and greater AUC0–24h values for FEV₁, FVC and IC.
• Trough FEV₁ and FVC values were also greater in the combination group.

Conclusion : A combination of tiotropium plus formoterol administered via a single inhaler produced a superior bronchodilator response than tiotropium alone over a period of 24 h.

Authors : Sundeep Salvia, Dipti Gothib, Vinaya Karkhanisb, Sapna Madasa, Jaideep Gogtayc, Jyotsna Joshib
Source : Pulmonary Pharmacology & Therapeutics,Volume 27, Issue 1, February 2014, Pages 90–95
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