No Loeffing Matter: The Dilemma of Loeffler's Endocarditis
A 69 year-old woman presented to the emergency department with one week of progressively worsening shortness of breath. The dyspnea worsened with exertion and was alleviated with rest. Associated symptoms included orthopnea, lower extremity edema, and weight gain. Her medical history consisted of emphysema and hypothyroidism with no prior cardiac history. Her home medications were levothyroxine, an albuterol rescue inhaler, and tiotropium. She had no past surgeries and no family history of cardiac disease. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - October 10, 2019 Category: General Medicine Authors: Amir Farid, Bradley Stauber, Solomon Khamishon, Douglas Fedder, Dali Fan Tags: Diagnostic Dilemma Source Type: research

Characterizing Real-World Use Of Tiotropium In Asthma In The USA
(Source: Journal of Asthma and Allergy)
Source: Journal of Asthma and Allergy - October 7, 2019 Category: Allergy & Immunology Tags: Journal of Asthma and Allergy Source Type: research

As-needed ICS-LABA in Mild Asthma: What Does the Evidence Say?
AbstractFor the last three decades, the guidelines for asthma management have supported a stepwise therapeutic approach, based on the administration of controller medications (especially inhaled corticosteroids) complemented by on-demand use of rescue medication. Classically, the rescue medication recommended comprised short-acting β agonists (SABA). Some years ago, the use of Symbicort Maintenance and Reliever Therapy (SMART) demonstrated the benefits of a combination of budesonide-formoterol, an inhaled corticosteroid, and a long-acting β agonist (ICS-LABA) as rescue medication in moderate and severe asthma. Th...
Source: Drugs - October 4, 2019 Category: Drugs & Pharmacology Source Type: research

Single inhaler extrafine triple therapy in uncontrolled asthma (TRIMARAN and TRIGGER): two double-blind, parallel-group, randomised, controlled phase 3 trials
Publication date: Available online 30 September 2019Source: The LancetAuthor(s): Johann Christian Virchow, Piotr Kuna, Pierluigi Paggiaro, Alberto Papi, Dave Singh, Sandrine Corre, Florence Zuccaro, Andrea Vele, Maxim Kots, George Georges, Stefano Petruzzelli, Giorgio Walter CanonicaSummaryBackgroundTo date, no studies have assessed the efficacy of single-inhaler triple therapy in asthma. Here we report on two studies that compared the single-inhaler extrafine combination of beclometasone dipropionate (BDP; inhaled corticosteroid), formoterol fumarate (FF; long-acting β2 agonist), and glycopyrronium (G; long-acting mu...
Source: The Lancet - October 1, 2019 Category: General Medicine Source Type: research

Costs, exacerbations and pneumonia after initiating combination tiotropium olodaterol versus triple therapy for chronic obstructive pulmonary disease.
Authors: Palli SR, Buikema AR, DuCharme M, Frazer M, Kaila S, Juday T Abstract Aim: To compare health plan-paid costs, exacerbations and pneumonia outcomes for patients with chronic obstructive pulmonary disease (COPD) initiating combination tiotropium olodaterol (TIO + OLO) versus triple therapy (TT: long-acting muscarinic antagonist + long-acting β2 agonists + inhaled corticosteroid). Patients & methods: COPD patients initiating TIO + OLO or TT between 1 January 2014 and 30 June 2016 were identified from a managed care Medicare database and balanced for baseline ch...
Source: Journal of Comparative Effectiveness Research - September 30, 2019 Category: General Medicine Tags: J Comp Eff Res Source Type: research

Tiotropium Respimat ® add-on therapy to inhaled corticosteroids in patients with symptomatic asthma improves clinical outcomes regardless of baseline characteristics
Up to half of people with asthma still suffer from symptoms despite treatment. A drug that relaxes the smooth muscle in the airways, called tiotropium, reduces symptoms of asthma when it is added on top of other asthma drugs. Asthma patients are diverse. We wanted to see whether the drug works across different patients. To test this, we studied just over 1500 people with symptomatic moderate asthma. Some were given the drug tiotropium at one dose (5  μg) and some were given the drug at a lower dose (2.5 μg), once a day, on top of other asthma drugs. Other patients were given a placebo (a substance with no effect)...
Source: Respiratory Medicine - September 30, 2019 Category: Respiratory Medicine Authors: Thomas B. Casale, Ren é Aalbers, Eugene R. Bleecker, Eli O. Meltzer, Liliana Zaremba-Pechmann, Alberto de la Hoz, Huib A.M. Kerstjens Source Type: research

Efficacy and cardiovascular safety profile of dual bronchodilation therapy in chronic obstructive pulmonary disease: A bidimensional comparative analysis across fixed-dose combinations
Publication date: Available online 11 September 2019Source: Pulmonary Pharmacology & TherapeuticsAuthor(s): Paola Rogliani, Maria Gabriella Matera, Beatrice Ludovica Ritondo, Ilaria De Guido, Ermanno Puxeddu, Mario Cazzola, Luigino CalzettaAbstractDespite several long-acting β2-adrenoceptors agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed-dose combinations (FDCs) are currently approved in chronic obstructive pulmonary disease (COPD), there are limited findings concerning the direct comparison across the different LABA/LAMA FDCs. The aim of this study was to compare the efficacy/safety profile of appr...
Source: Pulmonary Pharmacology and Therapeutics - September 11, 2019 Category: Respiratory Medicine Source Type: research

Effects of lung deflation induced by tiotropium/olodaterol on the cardiocirculatory responses to exertion in COPD
Hyperinflation has been associated with negative cardiocirculatory consequences in patients with chronic obstructive pulmonary disease (COPD). These abnormalities are likely to worsen when the demands for O2 increase, e.g., under the stress of exercise. Thus, pharmacologically-induced lung deflation may improve cardiopulmonary interactions and exertional cardiac output leading to higher limb muscle blood flow and oxygenation in hyperinflated patients with COPD. (Source: Respiratory Medicine)
Source: Respiratory Medicine - September 10, 2019 Category: Respiratory Medicine Authors: Danilo C. Berton, Renata D. Marques, Brandon Palmer, Denis E. O'Donnell, J.Alberto Neder Source Type: research

Tiotropium: An Effective Bronchodilator in Severe Asthma Independent of Type 2 Inflammation
Publication date: September–October 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 7Author(s): W. Gerald Teague (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - September 5, 2019 Category: Allergy & Immunology Source Type: research

Tiotropium Is Efficacious in 6- to 17-Year-Olds with Asthma, Independent of T2 Phenotype
ConclusionsThis exploratory analysis suggests that improvements with tiotropium as add-on to ICSs, with or without additional controllers, in 6- to 17-year-olds with symptomatic asthma do not vary according to systemic markers of T2 inflammation, namely, total IgE and blood eosinophil counts. (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - September 5, 2019 Category: Allergy & Immunology Source Type: research

Correlation of Inhaled Long-Acting Bronchodilators With Adverse Cardiovascular Outcomes in Patients With Stable COPD: A Bayesian Network Meta-Analysis of Randomized Controlled Trials
In conclusion, among these 3 kinds of ILABs, including LAMAs, LABAs, and LABAs/LAMAs, for stable COPD patients, LAMAs and LABAs are associated with the least possibility to induce myocardial infarction and stroke, respectively. However, the application of LABAs will probably increase the risk of CF; they should be used with caution for stable COPD patients with CF. In addition, in specific-drug analysis, the use of formoterol can reduce the risk of treatment-related IHD. Nevertheless, more studies on different drug doses are needed in the future to further validate this conclusion. (Source: Journal of Cardiovascular Pharmacology)
Source: Journal of Cardiovascular Pharmacology - September 1, 2019 Category: Cardiology Tags: Original Article Source Type: research

Are We Using the Correct Inhaled Medication to Treat Mild Asthma With Low Sputum Eosinophilia?
Synopsis: This crossover trial evaluated the efficacy of inhaled corticosteroids and long-acting muscarinic antagonists compared with placebo in asthmatic patients in relation to sputum eosinophil counts. No statistical significance was found between the Mometasone versus placebo or the Tiotropium versus placebo groups, and the responses to the active drugs were not greater than the responses to the placebo medications in those with a low sputum eosinophil count. Source: Lazarus SC, Krishnan JA, King TS, et al. Mometasone or Tiotropium in mild asthma with a low sputum eosinophil level. NEJM. 2019;380:2009–2019. (Sou...
Source: Clinical Pulmonary Medicine - September 1, 2019 Category: Respiratory Medicine Tags: Pulmonary Trends Source Type: research

Pharmacological Modulation of Endotoxin-Induced Release of IL-26 in Human Primary Lung Fibroblasts
Conclusions: The HLF constitute an abundant source of IL-26 that may contribute to local host defense against Gram-negative bacteria. Among the tested drugs, the glucocorticoid displayed the most powerful inhibitory effect, affecting the NF-κB, p38, and ERK1/2 signaling pathways. Whether or not this inhibition of IL-26 contributes to an increased risk for local infections in COPD requires further evaluation. (Source: Frontiers in Pharmacology)
Source: Frontiers in Pharmacology - August 30, 2019 Category: Drugs & Pharmacology Source Type: research

Duaklir Pressair: Another LAMA/LABA Inhaler for COPD
Date: September 23, 2019 Issue #:  1581Summary:  The FDA has approvedDuaklir Pressair (Circassia), a fixed-dose combination of the long-acting muscarinic antagonist (LAMA) aclidinium bromide and the longacting beta2-adrenergic agonist (LABA) formoterol fumarate, for maintenance treatment of chronic obstructive pulmonary disease (COPD). Aclidinium/formoterol is the fifth LAMA/LABA combination to be approved in the US for this indication. (Source: The Medical Letter)
Source: The Medical Letter - August 29, 2019 Category: Drugs & Pharmacology Authors: admin Tags: aclidinium Anoro Ellipta Bevespi Aerosphere COPD Duaklir Pressair Formoterol Glycopyrrolate indacaterol Inspiolto Respimat Long-acting beta2-agonists Stiolto Respimat tiotropium/olodaterol Ultibro Breezehaler umeclidinium Utibr Source Type: research

Glycopyrronium/Formoterol: A Review in COPD
AbstractGlycopyrronium/formoterol (Bevespi Aerosphere®) is a fixed-dose combination of the long-acting muscarinic antagonist glycopyrronium bromide and the long-acting β2-agonist formoterol fumarate delivered via a pressurized metered dose inhaler (pMDI) and formulated using co-suspension delivery technology. It is approved in the USA and EU for use as maintenance treatment in patients with chronic obstructive pulmonary disease (COPD) and in Japan to relieve symptoms in patients with COPD. In the PINNACLE trials in patients with moderate to very severe COPD, glycopyrronium/formoterol was associated with significan...
Source: Drugs - August 29, 2019 Category: Drugs & Pharmacology Source Type: research

Bronchodilator efficacy of tiotropium/formoterol (18/12 µg once daily via a Discair® inhaler), tiotropium alone (18 µg by Handihaler®) or combined with formoterol (12 µg twice daily by Aerolizer®) in adults with moderate-to-severe stable COPD.
Bronchodilator efficacy of tiotropium/formoterol (18/12 µg once daily via a Discair® inhaler), tiotropium alone (18 µg by Handihaler®) or combined with formoterol (12 µg twice daily by Aerolizer®) in adults with moderate-to-severe stable COPD. Curr Med Res Opin. 2019 Aug 09;:1 Authors: Yildiz BP, Bayraktaroglu M, Gunen H Abstract OBJECTIVES: The bronchodilator efficacy of a once-daily fixed-dose combination of tiotropium/formoterol (18/12 µg administered via a dry-powder inhaler, Discair®) [TIO/FORMfixed group] versus a single-dose of tiotropium (18 µg) by ...
Source: Current Medical Research and Opinion - August 11, 2019 Category: Research Tags: Curr Med Res Opin Source Type: research

The Respimat ® Soft Mist Inhaler: Implications of Drug Delivery Characteristics for Patients
We report on the development of the Respimat® soft mist inhaler (SMI) and compare key attributes with metered-dose inhalers (MDIs) and dry powder inhalers (DPIs). The Respimat SMI, a pocket-sized device generating a single-breath, inhalable aerosol, was designed to enhance drug delivery to the lungs, reduce the requirements for patient coordination and inspiratory effort, and improve the patients ’ experience and ease of use. The drug deposition profile with Respimat SMI is favorable compared with MDIs and DPIs, with higher drug deposition to the lung and peripheral airways. The slow velocity and long spray durat...
Source: Clinical Drug Investigation - August 3, 2019 Category: Drugs & Pharmacology Source Type: research

Efficacy of tiotropium in treating patients with moderate-to-severe asthma: A meta-analysis and systematic review based on 14 randomized controlled trials
Conclusions: In this review, we summarized the significant effect of tiotropium for the treatment of moderate-to-severe asthma, mainly in increasing morning PEF, evening PEF, peak FEV and trough FEV based on high-quality RCTs. Nevertheless, no significant difference in peak FVC, trough FVC, AE and serious AE was found between the 2 groups. A close comparison of the 2 groups revealed that more high-quality larger-sample RCTs are needed to gather more strong evidence on the therapeutic efficacy and safety of tiotropium for clinical practice. (Source: Medicine)
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis. Source Type: research

Evaluation of patients’ real-world post-dispensing use and storage environments of tiotropium bromide Respimat® soft mist inhaler on its in vitro dose delivery and lung deposition
ConclusionsUsing the R under the fluctuating summer and winter environments of our patients would not affect its overall tiotropium bromide emission performance. The significant increase in the respirable mass of the RS and RW might be offset by the increase in particles
Source: Pulmonary Pharmacology and Therapeutics - July 26, 2019 Category: Respiratory Medicine Source Type: research

Correction to: Tiotropium/Olodaterol: A Review in COPD
The article Tiotropium/Olodaterol: A Review in COPD, written by Hannah. (Source: Drugs)
Source: Drugs - July 18, 2019 Category: Drugs & Pharmacology Source Type: research

Reduced Environmental Impact of the Reusable Respimat ® Soft Mist™ Inhaler Compared with Pressurised Metered-Dose Inhalers
ConclusionTogether, these data suggest that Respimat inhalers, and in particular the new reusable inhaler, can reduce the environmental impact associated with inhaler use.FundingBoehringer Ingelheim. (Source: Advances in Therapy)
Source: Advances in Therapy - July 17, 2019 Category: Drugs & Pharmacology Source Type: research

Pulmonary and cardiac drugs: clinically relevant interactions.
Authors: Olschewski H, Canepa M, Kovacs G Abstract Chronic heart and lung diseases are very common in the elderly population. The combination of chronic heart failure and chronic obstructive pulmonary disease (COPD) is also common and, according to current guidelines, these patients should be treated for both diseases. In patients with heart failure, beta-blockers are very important drugs because their use is associated with significantly improved morbidity and mortality. These beneficial effects were documented in patients with and without COPD, although theoretically there is a risk for bronchoconstriction, parti...
Source: Herz - July 14, 2019 Category: Cardiology Tags: Herz Source Type: research

Safety of tiotropium Respimat ® in black or African-American patients with symptomatic asthma
This study aimed to assess the safety of tiotropium Respimat®, compared with placebo, in black or Afric an-American patients. (Source: Respiratory Medicine)
Source: Respiratory Medicine - July 2, 2019 Category: Respiratory Medicine Authors: LeRoy M. Graham, Huib A.M. Kerstjens, Christian Vogelberg, Eckard Hamelmann, Stanley J. Szefler, Wendelgard Pisternick-Ruf, Michael Engel, Georges El Azzi, Anna Unseld, Michael B. Foggs Tags: Short communication Source Type: research

Experimental Study of Spiriva Respimat Soft Mist Inhaler Spray Characterization: Size Distributions and Velocity
Journal of Aerosol Medicine and Pulmonary Drug Delivery, Ahead of Print. (Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery)
Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery - June 28, 2019 Category: Respiratory Medicine Authors: Abubaker Alatrash Rym Mehri Nicholas Ogrodnik Edgar Matida Frank Fiorenza Source Type: research

Regional differences in rate of FEV1 decline in COPD: lessons from SUMMIT
A publication by Zhou et al. [1], who studied 841 patients from China with mild to moderate chronic obstructive pulmonary disease (COPD) (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I and II) for 2 years, documented a 22 mL per year beneficial effect of tiotropium compared with placebo on rate of forced expiratory volume in 1 s (FEV1). This effect was over three times larger than the 6 mL per year (95% CI 1 to 11 mL per year) reported by Decramer et al. [2] in the 2739 GOLD stage II patients from the 4-year UPLIFT trial. We hypothesised that the large difference in resu...
Source: European Respiratory Journal - June 27, 2019 Category: Respiratory Medicine Authors: Celli, B. R., Anderson, J. A., Brook, R. D., Calverley, P. M. A., Cowans, N. J., Crim, C., Martinez, F., Newby, D. E., Yates, J., Vestbo, J. Tags: Original Articles: Research letters Source Type: research

Tiotropium add-on therapy is safe and reduces seasonal worsening in paediatric asthma patients
There remains an unmet need for effective, well-tolerated therapeutic options in paediatric patients with not fully controlled asthma, for whom safety is of paramount importance. Data were pooled from five randomised, double-blind, placebo-controlled studies evaluating tiotropium 5 or 2.5 µg versus placebo add-on therapy in patients with symptomatic asthma aged 1–17 years. Analysis included adverse events (AEs) and serious AEs (SAEs) reported throughout and for 30 days following treatment. Of 1691 patients treated, 1119 received tiotropium. Reporting of AEs was low and comparable across all group...
Source: European Respiratory Journal - June 13, 2019 Category: Respiratory Medicine Authors: Vogelberg, C., Szefler, S. J., Vrijlandt, E. J. L. E., Boner, A. L., Engel, M., El Azzi, G., Vulcu, S. D., Moroni-Zentgraf, P. M., Eickmeier, O., Hamelmann, E. H. Tags: Asthma and allergy, Paediatric pulmonology Original Articles: Asthma Source Type: research

Tiotropium in asthma: From bench to bedside
Tiotropium is a long-acting muscarinic antagonist approved for maintenance treatment of asthma in children, adolescents, and adults in the United States, and recommended as add-on treatment for uncontrolled asthma despite treatment with inhaled corticosteroids and/or long-acting beta-2 agonists. This review traces the journey of tiotropium from its historical origins through early preclinical testing to human clinical trials and real-life studies. (Source: Respiratory Medicine)
Source: Respiratory Medicine - June 11, 2019 Category: Respiratory Medicine Authors: Lyndon Mansfield, Jonathan A. Bernstein Tags: Review article Source Type: research

Add-on Tiotropium in Chinese Patients With Moderate Asthma: A Pooled Subgroup Analysis of MezzoTinA-Asthma 1 and 2.
This study aimed to assess the efficacy and safety of tiotropium in Chinese patients with moderate symptomatic asthma. METHODS: A post hoc subgroup analysis was conducted on 430 Chinese patients pooled from two 24-week, replicate phase 3 trials (NCT01172808 and NCT01172821), in which they received once-daily tiotropium 2.5 μg (Tio R2.5) or 5 μg (Tio R5) (n = 106 or 109, respectively), twice-daily salmeterol 50 μg (Sal 50) (n = 110), or placebo (n = 105), while maintaining inhaled corticosteroids (ICS). The co-primary endpoints assessed in week 24 were forced expiratory volume in 1 second (FEV1) peak0-3h respon...
Source: Allergy, Asthma and Immunology Research - June 8, 2019 Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research

Urine tropenol ester levels in workers handling tiotropium bromide synthesis: implications for exposure prevention and biomonitoring.
ch B Abstract Tropenol ester is a highly toxic anticholinergic substance and an intermediate used in industrial production of the bronchodilator tiotropium bromide. The aim of this study was to systematically test workers involved in its production for tropenol ester in urine to identify any exposure pathways and define additional preventive measures. Twelve workers performing tasks involving potential exposure to tropenol ester were repeatedly monitored at the end of each production cycle. Medical exams revealed no symptoms of acute poisoning with tropenol ester, but biological monitoring of urine showed 36 posit...
Source: Arhiv za Higijenu Rada i Toksikologiju - June 1, 2019 Category: Occupational Health Authors: Muttray A, Schneider M, Roßbach B Tags: Arh Hig Rada Toksikol Source Type: research

Cardiovascular safety of revefenacin, a once-daily, lung-selective, long-acting muscarinic antagonist for nebulized therapy of chronic obstructive pulmonary disease: Evaluation in phase 3 clinical trials
Publication date: Available online 30 May 2019Source: Pulmonary Pharmacology & TherapeuticsAuthor(s): James F. Donohue, Gregory Feldman, Sanjay Sethi, Chris N. Barnes, Srikanth Pendyala, David Bourdet, Glenn CraterAbstractThe cardiovascular safety of revefenacin, an anticholinergic indicated for the maintenance treatment of patients with chronic obstructive lung disease (COPD), was evaluated in phase 3 trials in patients with moderate to very severe COPD. No clinically meaningful changes in 12-lead electrocardiogram recordings were observed with up to 52 weeks of once-daily revefenacin 88 or 175 μg. In a pooled an...
Source: Pulmonary Pharmacology and Therapeutics - May 31, 2019 Category: Respiratory Medicine Source Type: research

Tiotropium/Olodaterol: A Review in COPD
AbstractTiotropium/olodaterol (Stiolto® Respimat®; Spiolto® Respimat®) is an inhaled fixed-dose combination of the long-acting muscarinic antagonist tiotropium bromide (hereafter referred to as tiotropium) and the long-acting β2-adrenergic agonist olodaterol. It is available in several countries, including the USA, Japan, China and those of the EU, where it is indicated for the long-term maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). The efficacy of tiotropium/olodaterol 5/5  μg/day in patients with COPD was evaluated in phase III or IV trials of 6&nda...
Source: Drugs - May 22, 2019 Category: Drugs & Pharmacology Source Type: research

Mometasone or Tiotropium in Mild Asthma with a Low Sputum Eosinophil Level
New England Journal of Medicine, Ahead of Print. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 19, 2019 Category: Internal Medicine Authors: Stephen C. Lazarus Jerry A. Krishnan Tonya S. King Jason E. Lang Kathryn V. Blake Ronina Covar Njira Lugogo Sally Wenzel Vernon M. Chinchilli David T. Mauger Anne-Marie Dyer Homer A. Boushey John V. Fahy Prescott G. Woodruff Leonard B. Bacharier Michael D Source Type: research

Efficacy and safety of the dual bronchodilator combination umeclidinium/vilanterol in COPD by age and airflow limitation severity: A pooled post hoc analysis of seven clinical trials
This study compared the efficacy and safety of a long-acting muscarinic antagonist/long-acting β2-agonist dry powder combination in elderly patients with COPD and patients with moderate-to-very severe airflow limitation.MethodsThis post hoc pooled analysis of seven randomized studies of ≥12 weeks’ duration investigated the efficacy and safety of umeclidinium/vilanterol (UMEC/VI) 62.5/25 μg versus tiotropium (TIO) 18 μg or fluticasone propionate/salmeterol (FP/SAL) 250/50 μg. Change from baseline in trough forced expiratory volume in 1 s (FEV1), a common efficacy measure in all trials, proport...
Source: Pulmonary Pharmacology and Therapeutics - May 14, 2019 Category: Respiratory Medicine Source Type: research

Effect of tiotropium inhaler use on mortality in patients with tuberculous destroyed lung: based on linkage between hospital and nationwide health insurance claims data in South Korea
Although bronchodilator inhaler therapy can improve lung function in patients with tuberculous destroyed lung (TDL), its effect on mortality has not been studied. We evaluated the effect of tiotropium inhaler ... (Source: Respiratory Research)
Source: Respiratory Research - May 6, 2019 Category: Respiratory Medicine Authors: Ho Cheol Kim, Tae Hoon Kim, Ye-Jee Kim, Chin Kook Rhee and Yeon-Mok Oh Tags: Research Source Type: research

Use of aclidinium did not increase the risk of death in a noninterventional cohort study in the Clinical Practice Research Datalink (CPRD), United Kingdom
Aclidinium bromide is an inhaled long-acting muscarinic antagonist (LAMA). Although the initial potential increased cardiovascular and mortality risk among users of tiotropium has been ruled out by several observational studies, and clinical trials, there are still concerns related to the use of newer LAMA medications. The current study aimed to evaluate the risk of death among users of aclidinium and other LAMAs. (Source: Respiratory Medicine)
Source: Respiratory Medicine - April 26, 2019 Category: Respiratory Medicine Authors: Cristina Rebordosa, Jaume Aguado, Estel Plana, Steven Thomas, Ana Frances, Alejhandra Lei, Esther Garc ía-Gil, Javier Nuevo, Susana Perez-Gutthann, Jordi Castellsague Source Type: research

Single Inhaler LABA/LAMA for COPD
Mario Malerba1,2*, Valentina Foci1,2, Filippo Patrucco1,2, Patrizia Pochetti1,2, Matteo Nardin3, Corrado Pelaia4 and Alessandro Radaeli5 1Respiratory Medicine, Department of Translational Medicine, University of Eastern Piedmont, Vercelli, Italy 2Respiratory Unit, Sant’Andrea Hospital, Vercelli, Italy 3Department of Medicine, Spedali Civili di Brescia, Brescia, Italy 4Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University “Magna Græcia” of Catanzaro, Catanzaro, Italy 5Department of Emergency, Spedali Civili di Brescia, Brescia, Italy Chronic obstructiv...
Source: Frontiers in Pharmacology - April 25, 2019 Category: Drugs & Pharmacology Source Type: research

The impact of patients' real-life environmental temperature and humidity use conditions of tiotropium dry powder inhaler on its aerosol emission characteristics.
CONCLUSIONS: The aerosol emission behaviour of tiotropium Handihaler was tolerant to real-life retention environments of patients in Amman, Jordan. PMID: 30946963 [PubMed - as supplied by publisher] (Source: European Journal of Pharmaceutical Sciences)
Source: European Journal of Pharmaceutical Sciences - April 1, 2019 Category: Drugs & Pharmacology Authors: Ammari WG, Mohammad MK, Tayyem RF Tags: Eur J Pharm Sci Source Type: research

Dual bronchodilation with tiotropium/olodaterol further reduces activity-related breathlessness versus tiotropium alone in COPD
The 3-min constant speed shuttle test (CSST) was used to examine the effect of tiotropium/olodaterol compared with tiotropium at reducing activity-related breathlessness in patients with chronic obstructive pulmonary disease (COPD). This was a randomised, double-blind, two-period crossover study including COPD patients with moderate to severe pulmonary impairment, lung hyperinflation at rest and a Mahler Baseline Dyspnoea Index
Source: European Respiratory Journal - March 28, 2019 Category: Respiratory Medicine Authors: Maltais, F., Aumann, J.-L., Kirsten, A.-M., Nadreau, E., Macesic, H., Jin, X., Hamilton, A., O'Donnell, D. E. Tags: COPD and smoking Original Articles: COPD Source Type: research

Tiotropium is efficacious in 6–17-year-olds with asthma, independent of T2 phenotype
ConclusionsThis exploratory analysis suggests that improvements with tiotropium as add-on to ICS, with or without additional controllers, in 6–17-year-olds with symptomatic asthma do not vary according to systemic markers of T2 inflammation, namely total IgE and blood eosinophil counts. (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - March 26, 2019 Category: Allergy & Immunology Source Type: research

Primary care of asthma: new options for severe eosinophilic asthma.
CONCLUSIONS: A new class of agents is available for patients with moderate to severe eosinophilic asthma. Four biologic therapies - mepolizumab, reslizumab, benralizumab, and dupilumab - that interfere with the regulation and activity of eosinophils have been approved by the FDA for patients with moderate to severe asthma with an eosinophilic phenotype. Primary care physicians should be familiar with these medications to explain part of the rationale for referral to specialist care and manage patient expectations for treatment. PMID: 30880484 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)
Source: Current Medical Research and Opinion - March 20, 2019 Category: Research Tags: Curr Med Res Opin Source Type: research

Tiotropium reduces airflow obstruction in asthma patients, independent of body mass index
Publication date: Available online 19 March 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Sandhya Khurana, Pierluigi Paggiaro, Roland Buhl, Jonathan A. Bernstein, Jennifer Haddon, Anna Unseld, Michael Engel, Thomas B. Casale, Anne E. Dixon (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - March 19, 2019 Category: Allergy & Immunology Source Type: research

Pharmacological characterization of the interaction between tiotropium bromide and olodaterol on human bronchi and small airways
In this study we have characterized the interaction between the LAMA, tiotropium bromide, and the LABA, olodaterol, on the contractile tone of human medium bronchi and small airways. The response to a combination of tiotropium bromide and olodaterol was assessed at sub-maximal contractile tone induced by carbachol. The duration of action was studied in tissue contracted by transmural stimulation. Relaxation of bronchial tone was expressed as % of maximal response to papaverine. Drug interactions were analyzed by the Bliss Independence method and Unified Theory. Tiotropium bromide/olodaterol combinations induced a significa...
Source: Pulmonary Pharmacology and Therapeutics - March 12, 2019 Category: Respiratory Medicine Source Type: research

Corrigendum to "Managing Severe Asthma: A Role for the Long-Acting Muscarinic Antagonist Tiotropium".
Corrigendum to "Managing Severe Asthma: A Role for the Long-Acting Muscarinic Antagonist Tiotropium". Biomed Res Int. 2019;2019:8515804 Authors: Hamelmann E Abstract [This corrects the article DOI: 10.1155/2018/7473690.]. PMID: 30834277 [PubMed] (Source: Biomed Res)
Source: Biomed Res - March 6, 2019 Category: Research Authors: Hamelmann E Tags: Biomed Res Int Source Type: research

Dose Determination for a Fixed-Dose Drug Combination: A Phase II Randomized Controlled Trial for Tiotropium/Olodaterol Versus Tiotropium in Patients with COPD
AbstractIntroductionDuring the clinical development of a fixed-dose combination of drugs, it is best practice to conduct dose-finding studies to determine the optimal dose of each component. The aims of this phase II dose-finding study were to confirm the lung function benefit of adding olodaterol to tiotropium, describe the dose –response relationship of olodaterol in combination with tiotropium 5 μg, and compare it with the dose response of olodaterol monotherapy.MethodsIn this double-blind, parallel-group trial, patients were randomized to receive either tiotropium 5  μg or a fixed-dose combin...
Source: Advances in Therapy - March 6, 2019 Category: Drugs & Pharmacology Source Type: research

Comparative Effectiveness of Two Tiotropium Formulations: A Retrospective Cohort Study.
This study confirms the findings observed in the TIOSPIR trial in a more heterogeneous population that included patient subgroups with severe respiratory disease and unstable COPD. PMID: 30822243 [PubMed - in process] (Source: COPD: Journal of Chronic Obstructive Pulmonary Disease)
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - March 5, 2019 Category: Respiratory Medicine Tags: COPD Source Type: research

Bu-Shen-Yi-Qi formula ameliorates airway remodeling in murine chronic asthma by modulating airway inflammation and oxidative stress in the lung
Publication date: April 2019Source: Biomedicine & Pharmacotherapy, Volume 112Author(s): Jie Cui, Fei Xu, Zhao Tang, Wenqian Wang, Ling li Hu, Chen Yan, Qingli Luo, Hongjian Gao, Ying Wei, Jingcheng DongAbstractBu-Shen-Yi-Qi formula (BSYQF) could suppress chronic airway inflammation according to previous studies. However, there is relatively little direct experimental evidence to evaluate the effects of BSYQF treatment on airway remodeling in chronic asthma. Recent evidence suggests that oxidative stress is involved in airway inflammation and airway remodeling in chronic asthma. BSYQF which includes various of chemical ...
Source: Biomedicine and Pharmacotherapy - February 23, 2019 Category: Drugs & Pharmacology Source Type: research

Bu-Shen-Yi-Qi formula ameliorates airway remodeling in murine chronic asthma by modulating airway inflammation and oxidative stress in the lung.
Abstract Bu-Shen-Yi-Qi formula (BSYQF) could suppress chronic airway inflammation according to previous studies. However, there is relatively little direct experimental evidence to evaluate the effects of BSYQF treatment on airway remodeling in chronic asthma. Recent evidence suggests that oxidative stress is involved in airway inflammation and airway remodeling in chronic asthma. BSYQF which includes various of chemical components having antioxidant effects, could be beneficial in attenuating airway remodeling in chronic asthma. The purpose of this study was to elucidate the effect of BSYQF treatment on airway re...
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - February 21, 2019 Category: Drugs & Pharmacology Authors: Cui J, Xu F, Tang Z, Wang W, Hu LL, Yan C, Luo Q, Gao H, Wei Y, Dong J Tags: Biomed Pharmacother Source Type: research

Fixed-Dose Combinations of Long-Acting Bronchodilators for the Management of COPD: Global and Asian Perspectives
AbstractMaintenance bronchodilator therapy with long-acting β-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) is the cornerstone treatment for patients with stable chronic obstructive pulmonary disease (COPD). Fixed-dose combinations (FDCs) of LABA/LAMA are recommended for the majority of symptomatic COPD patients by global guidelines; regio nal guidelines such as the Japanese and Korean guidelines also provide similar recommendations for the use of LABA/LAMA FDCs. This review comprehensively describes the latest clinical evidence from key studies on the efficacy and safety of four approved LABA/LAMA f...
Source: Advances in Therapy - February 11, 2019 Category: Drugs & Pharmacology Source Type: research

The effect of muscarinic M3 receptor blockage in development of M2 macrophages in allergic inflammation
We have reported that muscarinic M3 receptor antagonist (tiotropium) inhibits the allergic airway inflammation in murine model of asthma. However, the mechanism is still unclear. The purpose of this study is to investigate the effect of muscarinic M3 receptor blockage in development of M2 macrophages in allergic inflammation. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2019 Category: Allergy & Immunology Authors: Shin Ohta, Megumi Jinno, Akihiko Tanaka, Tomoki Uno, Yoshitaka Uchida, Ryo Manabe, Hitomi Ida, Naota Kuwahara, Yosuke Fukuda, Tomoyuki Kimura, Kukniaki Hirai, Yoshito Miyata, Munehiro Yamaguchi, Tetsuya Homma, Fumihiro Yamaguchi, Yoshio Watanabe, Shintaro Source Type: research

Tiotropium Provides Greater Improvements In FEV1 Than An LTRA As Add-On To ICS In Children And Adolescents With Asthma: A Systematic Review
This literature review compares the reported efficacy of tiotropium and leukotriene receptor antagonists (LTRAs) as add-on to ICS in children and adolescents with asthma. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2019 Category: Allergy & Immunology Authors: Stanley Goldstein, Christian Vogelberg, LeRoy Graham, Alberto de la Hoz, Kimberley Kallsen, Eckard H. Hamelmann Source Type: research