Tiotropium in chronic obstructive pulmonary disease – a review of clinical development
Bronchodilators are the mainstay of pharmacological treatment in chronic obstructive pulmonary disease (COPD), and long-acting muscarinic antagonist (LAMA) monotherapy is recommended as initial treatment for G... (Source: Respiratory Research)
Source: Respiratory Research - July 29, 2020 Category: Respiratory Medicine Authors: Antonio Anzueto and Marc Miravitlles Tags: Review Source Type: research

The reality of LAMAs for adult asthmatic patients.
Authors: Luz MI, Aguiar R, Morais-Almeida M Abstract INTRODUCTION: The use of tiotropium is approved for the treatment of asthma. There are several studies completed or currently ongoing with the long-acting muscarinic antagonists (LAMAs) umeclidinium and glycopyrronium as an add-on asthma treatment. Adding a second bronchodilator with a different mechanism of action for the treatment of uncontrolled asthma may be a suitable therapeutic approach, although several issues still under discussion. AREAS COVERED: The reality of LAMA plus long-acting beta-agonists (LABA) treatment for adult asthma. A systematic searc...
Source: Expert Review of Respiratory Medicine - July 21, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Viruses, Vol. 12, Pages 776: Tiotropium is Predicted to be a Promising Drug for COVID-19 Through Transcriptome-Based Comprehensive Molecular Pathway Analysis
In this study, we dissected molecular pathways upregulated in SARS-CoV-2-infected normal human bronchial epithelial (NHBE) cells by analyzing an RNA-seq data set with various bioinformatics approaches, such as gene ontology, protein–protein interaction-based network and gene set enrichment analyses. The results indicated that the SARS-CoV-2 infection strongly activates TNF and NFκB-signaling pathways through significant upregulation of the TNF, IL1B, IL6, IL8, NFKB1, NFKB2 and RELB genes. In addition to these pathways, lung fibrosis, keratinization/cornification, rheumatoid arthritis, and negati...
Source: Viruses - July 20, 2020 Category: Virology Authors: Keunsoo Kang Hoo Hyun Kim Yoonjung Choi Tags: Article Source Type: research

Efficacy of Tiotropium/Olodaterol Compared with Tiotropium as a First-Line Maintenance Treatment in Patients with COPD Who Are Na ïve to LAMA, LABA and ICS: Pooled Analysis of Four Clinical Trials
AbstractIntroductionThe efficacy of tiotropium/olodaterol compared with tiotropium in patients with chronic obstructive pulmonary disease (COPD) has been demonstrated in a large clinical programme. Currently, randomised controlled trial (RCT) data on dual bronchodilation as first-line maintenance therapy are limited. In this post hoc analysis of pooled data from four RCTs, we compared the efficacy of tiotropium/olodaterol versus tiotropium as maintenance therapy in patients with COPD who were not receiving maintenance treatment with long-acting muscarinic antagonists (LAMAs), long-acting β2-agonists (LABAs) or inhaled...
Source: Advances in Therapy - July 15, 2020 Category: Drugs & Pharmacology Source Type: research

Tiotropium and Fluticasone Inhibit Rhinovirus-Induced Mucin Production via Multiple Mechanisms in Differentiated Airway Epithelial Cells
Human rhinoviruses (HRVs) are associated with acute exacerbations in patients with chronic obstructive pulmonary disease (COPD) and asthma, which are accompanied by mucus hypersecretion. Whereas, various studies have shown that HRVs increase epithelial mucin production and thus may directly contribute to mucus hypersecretion. The effects of drugs used in the treatment of COPD and asthma on HRV-induced mucin production in epithelial cell cultures have not been studied. In the present study, we assessed effects of HRVs on mucin production and secretion in well-differentiated primary human bronchial epithelial cells (PBEC) an...
Source: Frontiers in cellular and infection microbiology - June 19, 2020 Category: Microbiology Source Type: research

Socheongryongtang suppresses COPD-related changes in the pulmonary system through both cytokines and chemokines in a LPS COPD model.
This study investigated the therapeutic mechanism of socheongryongtang for pulmonary diseases.Materials and methods: Seventy BALB/c mice were used: control, 0.8 mg/kg/study LPS intranasal instillation, 1 mg/kg/day Spiriva oral administration for five days, two socheongryongtang groups (150 or 1500 mg/kg/day orally treatment for five days). To illuminate the anti-COPD mechanism, several factors were evaluated such as WBC and differential counts in BALF and IgE in serum, morphological changes, and changes of COPD-related cytokines (TNF-α, IFN-γ, TGF-β) and chemokines (CXCL1...
Source: Pharmaceutical Biology - June 10, 2020 Category: Drugs & Pharmacology Tags: Pharm Biol Source Type: research

Benefits of Tiotropium/Olodaterol Compared with Tiotropium in Patients with COPD Receiving only LAMA at Baseline: Pooled Analysis of the TONADO ® and OTEMTO ® Studies
AbstractIntroductionThe Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy report recommends long-acting muscarinic antagonists (LAMA) or long-acting β2-agonists (LABA) as first-line treatment for chronic obstructive pulmonary disease (COPD), but many patients remain symptomatic on monotherapy and escalation to dual-bronchodilator therapy may be warranted.MethodsTONADO® 1&2 and OTEMTO® 1&2 assessed lung function and patient-reported outcomes in patients with moderate-to-severe (OTEMTO) or moderate-to-very-severe (TONADO) COPD. This pooled post hoc analysis included patients treated ...
Source: Advances in Therapy - May 27, 2020 Category: Drugs & Pharmacology Source Type: research

Fixed-dose combination of indacaterol/glycopyrronium/mometasone furoate once-daily versus salmeterol/fluticasone twice-daily plus tiotropium once-daily in patients with uncontrolled asthma: A randomised, Phase IIIb, non-inferiority study (ARGON)
The efficacy and safety of once-daily (o.d.) fixed-dose combination of indacaterol (IND), glycopyrronium (GLY) and mometasone furoate (MF) via Breezhaler ® versus concurrent administration of salmeterol/fluticasone (SAL/FLU) twice-daily (b.i.d.) via Accuhaler®+Tiotropium (TIO) o.d. via Respimat® was evaluated in patients with uncontrolled asthma. (Source: Respiratory Medicine)
Source: Respiratory Medicine - May 26, 2020 Category: Respiratory Medicine Authors: Christian Gessner, Oliver Kornmann, Jorge Maspero, Richard van Zyl-Smit, Matthias Kr üll, Anna Salina, Pritam Gupta, Sebastien Bostel, Sebastian Fucile, Lorena Garcia Conde, Pascal Pfister Source Type: research

Herbal Medication, Macmoondong Decoction, Attenuates LPS-Induced COPD in Small Airways via TGF- β, CCL-2, and CXCL1.
Herbal Medication, Macmoondong Decoction, Attenuates LPS-Induced COPD in Small Airways via TGF-β, CCL-2, and CXCL1. Evid Based Complement Alternat Med. 2020;2020:6413491 Authors: Lee SY, Kang B, Bae CS, Cho SS, Park DH Abstract Chronic obstructive pulmonary disease (COPD) is an incurable disease related to the respiratory system. A 2017 report by the World Health Organization stated that it was the third most common cause of death in 2015. Macmoondong decoction is a prescription that has been used widely in Korea for the treatment of respiratory diseases, but there have been few investigations int...
Source: Evidence-based Complementary and Alternative Medicine - May 10, 2020 Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research

Can tiotropium add-on therapy safely improve clinical outcomes in children and adolescents with persistent asthma?
Tiotropium, a long-acting form of anticholinergic bronchodilator, has been indicated for the treatment of chronic obstructive pulmonary disease for over 10 years, followed by its more recent approval for use in patients with asthma. In 2014, tiotropium administered through Respimat ® Soft Mist inhaler (Boehringer Ingelheim, Ingelheim am Rhein, Germany), was indicated as the first long-acting muscarinic antagonists (LAMA) approved for asthma maintenance therapy. A systematic review and meta-analysis by Sobieraj et al1 demonstrated the association of ICS and LAMA with asthma co ntrol in uncontrolled persistent asthmatics...
Source: Annals of Allergy, Asthma and Immunology - May 3, 2020 Category: Allergy & Immunology Authors: Dan Yang, Qian Peng, Tingxuan Huang, Xinning Guo, Chuntao Liu Tags: Letters Source Type: research

Can tiotropium add-on therapy safely improve clinical outcomes in children and adolescents with persistent asthma?
PMID: 32371245 [PubMed - as supplied by publisher] (Source: Annals of Allergy, Asthma and Immunology)
Source: Annals of Allergy, Asthma and Immunology - May 1, 2020 Category: Allergy & Immunology Authors: Yang D, Peng Q, Huang T, Guo X, Liu C Tags: Ann Allergy Asthma Immunol Source Type: research

2019 Year in Review: Aerosol Therapy.
Abstract Relevant publications related to medicinal and toxic aerosols are discussed in this review. Treatment of COPD includes a combination of long-acting bronchodilators and long-acting muscarinic antagonists. A combination of aclidinium bromide and formoterol fumarate was approved in the United States. The combination was superior to its components alone, as well as tiotropium and a salmeterol-fluticasone combination. Increased risk of an asthma exacerbation was reported in children exposed to electronic nicotine delivery systems. A smart inhaler capable of recording inspiratory flow was approved in the United...
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Berlinski A Tags: Respir Care Source Type: research

New perspectives on the role of muscarinic antagonists in asthma therapy.
Authors: Matera MG, Belardo C, Rinaldi M, Rinaldi B, Cazzola M Abstract Introduction: Tiotropium is useful in the presence of severe uncontrolled asthma despite the optimization of therapy with inhaled corticosteroids (ICSs) and long-acting β2 agonists (LABAs) as recommended by the current guidelines. However, in recent years there has been some further preclinical and clinical evidence on the pharmacological and therapeutic impact of these agents.Areas covered: We have conducted an extensive search on muscarinic antagonists in asthma therapy throughout several sources and discuss what has emerged in the last ...
Source: Expert Review of Respiratory Medicine - April 24, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Emerging muscarinic receptor antagonists for the treatment of asthma.
Authors: Matera MG, Belardo C, Rinaldi M, Rinaldi B, Cazzola M Abstract Introduction: The critical role of acetylcholine in asthma pathophysiology and the increase in vagal tone are the main reasons why a LAMA is a good choice in the treatment of the asthmatic patient. Tiotropium is the only LAMA approved for use in asthma in many countries but there is a real interest in developing novel LAMAs for the treatment of asthma, or at least to extend this indication to other LAMAs already on the market.Areas covered: Trials that have studied or are evaluating the role of LAMAs already on the market in asthma and possible...
Source: Expert Opinion on Emerging Drugs - April 22, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Emerg Drugs Source Type: research

Tiotropium Respimat efficacy and safety in asthma: Relationship to age
Publication date: Available online 19 April 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Dennis E. Doherty, Eugene R. Bleecker, Petra Moroni-Zentgraf, Liliana Zaremba-Pechmann, Huib A.M. Kerstjens (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - April 21, 2020 Category: Allergy & Immunology Source Type: research

REPLY: RE: Yildiz BP, Bayraktaroglu M, Gunen H. 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;35(12):2187-2196.
REPLY: RE: Yildiz BP, Bayraktaroglu M, Gunen H. 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;35(12):2187-2196. Curr Med Res Opin. 2020 Apr 09;:1 Authors: Yildiz BP, Bayraktaroglu M, Gunen H PMID: 32270722 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)
Source: Current Medical Research and Opinion - April 11, 2020 Category: Research Tags: Curr Med Res Opin Source Type: research

RE: Yildiz BP, Bayraktaroglu M, Gunen H. 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;35(12):2187-2196.
RE: Yildiz BP, Bayraktaroglu M, Gunen H. 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;35(12):2187-2196. Curr Med Res Opin. 2020 Apr 09;:1 Authors: Kalemci S, Sarihan A, Kargı AB, Şimşek A, Zeybek A PMID: 32270717 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)
Source: Current Medical Research and Opinion - April 11, 2020 Category: Research Tags: Curr Med Res Opin Source Type: research

Association of tiotropium use and the risk of adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials
ConclusionsInhaled tiotropium does not increase the risk of cardiovascular events and cardiovascular mortality in patients with COPD. (Source: European Journal of Clinical Pharmacology)
Source: European Journal of Clinical Pharmacology - April 10, 2020 Category: Drugs & Pharmacology Source Type: research

Re-evaluation of the uplift clinical trial, using age-appropriate spirometric criteria.
RE-EVALUATION OF THE UPLIFT CLINICAL TRIAL, USING AGE-APPROPRIATE SPIROMETRIC CRITERIA. Chest. 2020 Apr 09;: Authors: Vaz Fragoso CA, Leo-Summers LS, Gill TM, McAvay GJ Abstract BACKGROUND: The clinical trial of tiotropium in chronic obstructive pulmonary disease (COPD), i.e. UPLIFT, enrolled adults with a mean age of 65 years and moderate-to-severe airflow-obstruction, based on criteria from the Global Initiative for Chronic Obstructive Lung Disease (GOLD). For the UPLIFT cohort, however, GOLD-based criteria are not age-appropriate. RESEARCH QUESTION: Will the use of more age-appropriate criteri...
Source: Chest - April 9, 2020 Category: Respiratory Medicine Authors: Vaz Fragoso CA, Leo-Summers LS, Gill TM, McAvay GJ Tags: Chest Source Type: research

Adding a Second Bronchodilator in COPD: A Meta-Analysis on the Risk of Specific Cardiovascular Serious Adverse Events of Tiotropium/Olodaterol Fixed-Dose Combination.
This study aimed to ascertain whether tiotropium/olodaterol (T/O) 5/5 μg fixed-dose combination (FDC) may modulate the risk of main cardiovascular outcomes in COPD patients enrolled in randomized controlled trials (RCTs). A meta-analysis (CRD42017070100) was performed by selecting RCTs reporting raw data from the ClinicalTrials.gov database concerning the impact of T/O 5/5 µg FDC vs. monocomponents on the occurrence of specific cardiovascular serious adverse events: arrhythmia, heart failure, myocardial infarction, and stroke. Data were reported as relative risk and 95% Confidence Interval, and the r...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - April 8, 2020 Category: Respiratory Medicine Tags: COPD Source Type: research

The Design of and Rationale for the Effect of Perioperative Inhaled Tiotropium for Patients with Chronic Obstructive Pulmonary Disease in Esophageal Cancer Surgery (EPITOPE): an Open-Label, Randomized, Parallel-Group Study
This study investigates the effect of perioperative inhaled tiotropium on patients with COPD who undergo esophagectomy. It is an open-label, randomized controlled trial conducted in a single center (EPITOPE study). A total of 32 enrolled patients are randomly assigned in a 1:1 ratio to either conventional management or inhalation of tiotropium in addition to the conventional management. Patients included in the intervention group receive tiotropium Respimat 5 μg (two inhalations of 2.5 μg) for at least 2 weeks before the esophagectomy. Following the esophagectomy, tiotropium is re-delivered, starting as early as poss...
Source: European Surgical Research - April 3, 2020 Category: Surgery Source Type: research

A comparison of tiotropium/olodaterol vs tiotropium alone in terms of treatment effect for chronic obstructive pulmonary disease: A meta-analysis
Conclusion: These studies reported that the TIO/OLO combination did not show superior effects than tiotropium alone for COPD. Additionally, both therapies were well tolerated. (Source: Medicine)
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Exacerbation Rates and Healthcare Resource Utilization (HRU) in Asthma Patients Initiating Tiotropium Respimat (Tio-RMT)
To characterize real-world outcomes in asthma patients initiating Tio-RMT, a LAMA soft-mist inhaler approved for long-term maintenance treatment of asthma in patients aged ≥6 years. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2020 Category: Allergy & Immunology Authors: Swetha Palli, Jay Visaria, Sonali Shambhu, Vince Willey, Asif Shaikh Source Type: research

Real-life study on the efficacy of tiotropium bromide in pediatric severe asthma
There are evidence of efficacy and safety of Tiotropium Bromide in severe asthma in children. The aim of this study was evaluate the efficacy of Tiotropium Bromide (TB) in children with severe asthma using clinical and lung function parameters. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2020 Category: Allergy & Immunology Authors: Juliana Murata, Jessica Drobrzenski, Caroline Ferreira, Nathalia Vital, Renata Dias, Dirceu Sole, Nelson Rosario, Antonio Pastorino, Herberto Chong Neto, Gustavo Wandalsen Source Type: research

Budesonide/formoterol therapy: effective and appropriate use in asthma and chronic obstructive pulmonary disease.
Conclusion: We found available, good quality BFC CE and appropriate-use articles; however, all had limitations. PMID: 31983228 [PubMed - as supplied by publisher] (Source: Journal of Comparative Effectiveness Research)
Source: Journal of Comparative Effectiveness Research - January 28, 2020 Category: General Medicine Tags: J Comp Eff Res Source Type: research

Dual use of bronchodilators versus monotherapy, and its impact on pulmonary rehabilitation in COPD patients
Publication date: Available online 21 January 2020Source: Pulmonary Pharmacology & TherapeuticsAuthor(s): Vicente Benavides-Cordoba, Sebastian Aviles, Camila Asc.ar, Lina Orozco, Ricardo Mosquera, Julian RiveraAbstractIntroductionLong-acting bronchodilators are the therapy with the best evidence for treating stable chronic obstructive pulmonary disease (COPD). Long-acting combinations of β2 agonists and anticholinergics (LABA-LAMA) are recommended in advanced stages when monotherapy has not generated the desired effects. Pulmonary Rehabilitation (PR) is an effective non-pharmacological strategy. The aim of this st...
Source: Pulmonary Pharmacology and Therapeutics - January 22, 2020 Category: Respiratory Medicine Source Type: research

A comparison of tiotropium, long-acting β2-agonists and leukotriene receptor antagonists on lung function and exacerbations in paediatric patients with asthma
Diagnosing and treating asthma in paediatric patients remains challenging, with many children and adolescents remaining uncontrolled despite treatment. Selecting the most appropriate pharmacological treatment ... (Source: Respiratory Research)
Source: Respiratory Research - January 13, 2020 Category: Respiratory Medicine Authors: Christian Vogelberg, Stanley Goldstein, LeRoy Graham, Alan Kaplan, Alberto de la Hoz and Eckard Hamelmann Tags: Research Source Type: research

A comparison of tiotropium, long-acting β2-agonists and leukotriene receptor antagonists on lung function and exacerbations in paediatric patients with asthma.
In conclusion, this literature review provides an up-to-date overview of the efficacy and safety of LABAs, LTRAs and LAMAs as add-on to ICS in children and adolescents with asthma. Overall, tiotropium and LABAs have similar efficacy, and provide greater improvements in lung function than montelukast as add-on to ICS. All three controller options have comparable safety profiles. PMID: 31931792 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - January 13, 2020 Category: Respiratory Medicine Authors: Vogelberg C, Goldstein S, Graham L, Kaplan A, de la Hoz A, Hamelmann E Tags: Respir Res Source Type: research

Management of severe asthma: a European Respiratory Society/American Thoracic Society guideline
This document provides clinical recommendations for the management of severe asthma. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the European Respiratory Society/American Thoracic Society Task Force's questions. The evidence was appraised using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of asthma experts, who made specific recommendations on six sp...
Source: European Respiratory Journal - January 2, 2020 Category: Respiratory Medicine Authors: Holguin, F., Cardet, J. C., Chung, K. F., Diver, S., Ferreira, D. S., Fitzpatrick, A., Gaga, M., Kellermeyer, L., Khurana, S., Knight, S., McDonald, V. M., Morgan, R. L., Ortega, V. E., Rigau, D., Subbarao, P., Tonia, T., Adcock, I. M., Bleecker, E. R., B Tags: Original Articles: ERS/ATS guidelines Source Type: research

Tiotropium add-on therapy reduces seasonal peaks of asthma worsening in adults with symptomatic severe asthma
Despite the use of preferred controller therapies (including inhaled corticosteroids (ICS) with or without additional long-acting β2-agonists (LABAs)), a large proportion of patients with asthma have poor disease control, leaving them at risk of recurring symptoms and episodes of asthma exacerbations and worsening [1, 2]. Such problems can be triggered by many different environmental factors including pollutants, respiratory infections or allergens [3]. They may occur sporadically, but are often determined by the seasons, mirroring seasonal patterns of allergen exposure and prevalence of respiratory viral infection [3...
Source: European Respiratory Journal - January 2, 2020 Category: Respiratory Medicine Authors: FitzGerald, J. M., Buhl, R., Casale, T. B., Jugovic, B., Zaremba-Pechmann, L., Halpin, D. M. G. Tags: Original Articles: Research letters Source Type: research

Efficacy of once-daily tiotropium Respimat in adults with asthma at GINA Steps 2–5
In conclusion, Tiotropium Respimat add-on therapy improves lung function, and may improve asthma control, in adults across disease severities.Graphical abstract (Source: Pulmonary Pharmacology and Therapeutics)
Source: Pulmonary Pharmacology and Therapeutics - December 24, 2019 Category: Respiratory Medicine Source Type: research

Improving the Efficiency of Randomized Trials: The DYNAGITO Example.
Authors: Suissa S Abstract A traditional principle of the randomized controlled trial is that the p-value comparing treatment groups should be computed from the simple crude data. This assumes that the size of the study is sufficiently large for an accurate and precise estimation of the difference between groups. There are situations where the accuracy and precision of the study can be improved by statistical adjustment for baseline covariates, including when the outcome is continuous and available at baseline. The European Medicines Agency (EMA) and the Food and Drug Administration (FDA) recommend covariate adjust...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - December 5, 2019 Category: Respiratory Medicine Tags: COPD Source Type: research

Tiotropium in Children and Adolescents With Asthma
Asthma is a major cause of morbidity in children, despite the availability of various treatments. In adults, tiotropium —a long-acting muscarinic antagonist (LAMA)—as add-on therapy to an inhaled corticosteroid (ICS) with or without a long-acting β2-agonist provides clinical benefit with a safety profile similar to placebo. Objective: To review published evidence on the efficacy and safety of tiotropium as add-o n LAMA therapy in children and adolescents with asthma that is uncontrolled despite use of an ICS with or without additional controller medication(s). (Source: Annals of Allergy, Asthma and Immunology)
Source: Annals of Allergy, Asthma and Immunology - December 2, 2019 Category: Allergy & Immunology Authors: Kevin R. Murphy, Bradley E. Chipps Source Type: research

Tiotropium in Children and Adolescents With Asthma.
CONCLUSION: Once-daily tiotropium as add-on therapy is efficacious and safe in adolescents and children with moderate-to-severe asthma. These results support the expanded indication by regulatory authorities for add-on tiotropium in patients aged ≥6 years. PMID: 31805357 [PubMed - as supplied by publisher] (Source: Annals of Allergy, Asthma and Immunology)
Source: Annals of Allergy, Asthma and Immunology - December 2, 2019 Category: Allergy & Immunology Authors: Murphy KR, Chipps BE Tags: Ann Allergy Asthma Immunol Source Type: research

Drugs prescribed to patients with asthma and COPD before they present to tertiary care hospitals in Trivandrum, India
Conclusion: A high proportion of COPD/Asthma patients are treated with oral medications in India. Even though 34% of patients are prescribed inhaled medications before they reach tertiary care, there is a preference for a ICS over LAMA in COPD and only 30% of Asthma patients were prescribed an ICS. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Arjun, P., Nair, S. Tags: General practice and primary care Source Type: research

Mechanisms of acetylcholine-induced release of proinflammatory extracellular vesicles by endothelial cells and inhibitory effects of tiotropium
Conclusions: Muscarinic stimulation causes an ERK-dependent generation of proinflammatory EV by HUVEC cells that is inhibited by tiotropium. This observation could contribute to explain the effect of tiotropium in the reduction of acute exacerbations of COPD. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Neri, T., Scalise, V., Passalacqua, I., Sanguinetti, C., Lombardi, S., Pedrinelli, R., Paggiaro, P., Celi, A. Tags: Airway cell biology and immunopathology Source Type: research

Effects of tiotropium bromide and fluticasone propionate/salmeterol on myocardial ischemia in patients (pts) with COPD and stable angina during 24-hour ambulatory Holter ECG monitoring
Aim: to study influence of tiotropium bromide and fluticasone propionate/salmeterol on the severity of myocardial ischemia in pts with stable COPD group D and concomitant ischemic heart disease (IHD).Materials and Methods: We studied 67 pts in stable stage of COPD group D divided into 2 groups: 1st – 34 (50,7%) males (age – 63,9±7,1 yrs) with stable angina and arrhythmias taking tiotropium bromide (Spiriva®), 2nd – 33 (49,3%) males (age – 61,4±6,3 yrs) with angina alone taking fluticasone propionate/salmeterol (Seretide Diskus®), before and after 6-months course of complex trea...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Fesenko, O., Bielosludtseva, K., Bohatska, K. Tags: Airway pharmacology and treatment Source Type: research

Evaluation in administration of angiotensin II receptor antagonist Valsartan in the treatment of hypertension patients with chronic obstructive pulmonary disease
Purpose: to evaluate the efficacy and tolerance of administration of angiotensin II type receptor antagonist Valsartan in patients with chronic obstructive pulmonary hypertension associated.Material and Methods: 31 patients were examined, mean age 58.3 + 2.7 years; 29 men and 2 women with arterial hypertension (AH) associated with chronic obstructive pulmonary disease (COPD) degree II stable development (GOLD). According random method, patients were divided into 2 groups as per the medication used: first group - 14 patients were administered antihypertensive Valsartan with average dose 82,6±3,1 mg/day depending on t...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Calancea, V., Ghicavii, N., Cretu, A., Antonova, N., Oprea, S., Matcovschi, S. Tags: Airway pharmacology and treatment Source Type: research

The safety of LAMA/LABA combination therapy for the ocular and urinary adverse effects in the COPD patients
Conclusions: Our results showed the safety of the LAMA/LABA combination for the ocular and urinary adverse effects. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Ohtsuka, K., Maeda, C., Shinka, Y., Takahashi, T., Harada, N., Yagihashi, M., Fujitake, J., Udagawa, T., Miyao, N. Tags: Airway pharmacology and treatment Source Type: research

Effects of different classes of bronchodilators on pulmonary hemodynamics in patients with chronic obstructive pulmonary disease>
Background: Current guidelines recommend bronchodilators (Beta2-agonists, Anticholinergics, Methylxanthines) in stable chronic obstructive pulmonary disease (COPD), which have the ability to improve pulmonary ventilation. At the same time, the bronchodilators can act upon pulmonary hemodynamics.Material and Methods: The study included 106 patients (mean age 56.3±0.78 years) with stable COPD with GOLD stage I and II, divided into 3 groups, comparable by age, sex, duration and stage of the disease and duration of smoking. Patients in group 1 (n=30), inhaled 2 puffs of tiotropium bromide once daily; patients in group 2...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Calancea, V., Terna, E., Dumitras, T., Ghicavii, N., Popescu, A., Baba, D., Matcovschi, S. Tags: Airway pharmacology and treatment Source Type: research

Late Breaking Abstract - The efficacy of roflumilast in the treatment of COPD(stage B)
Background: COPD is a progressive condition involving chronic inflammation and parenchymal destruction with resulting airflow. Roflumilast has an anti-inflammatory effect including decreasing inflammatory mediators and the expression of cell surface markers, inhibition of apoptosis.Objective: The purpose of this study is to evaluate the efficacy of roflumilast in COPD(stage B).Methods: 332patients(291men and 41women, the mean age of 40-60), with the diagnosis of COPD (stage B) and FEV1
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Khachatryan, I., Narimanyan, M. Tags: Airway pharmacology and treatment Source Type: research

Late Breaking Abstract - Tiotropium/olodaterol improves pulmonary function in patients with treatment naive COPD
Background: The effects of pharmacologic treatment on physical activity (PA) are still unclear, especially in treatment naive patients with COPD. We investigated the effects of a newly introduced bronchodilator on pulmonary function, dyspnea, QOL and PA in COPD patients.Methods: In this prospective, randomized interventional study, 78 treatment naive COPD subjects without any other diseases that might reduce PA were recruited. The subjects were randomized to receive either tiotropium (Tio) or tiotropium/olodaterol (Tio/Olo) combination treatment for 12-weeks. PA levels were measured with a triaxle accelerometer for 2 weeks...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Takahashi, K., Uchida, M., Kato, G., Takamori, A., Sadamatsu, H., Tanaka, M., Tajiri, R., Kinoshita, T., Kojima, K., Yoshida, M., Tashiro, H., Hayashi, S., Kawaguchi, A., Sueoka-Aragane, N., Kawayama, T. Tags: Airway pharmacology and treatment Source Type: research

Late Breaking Abstract - Assessment of physical functioning and handling with Tiotropium/Olodaterol (T/O) in patients with COPD requiring long-acting dual bronchodilation in an Italian cohort of patients
Conclusion: This real-life study showed that physical functioning, general patients’ condition, and satisfaction with T/O Respimat® FDC and the device were high in general (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Pennisi, A., Carone, M., DAmato, M., Fiore Donati, A., Ronsivalle, V., Aliani, M., Scognamillo, C., Chun, L., Pelaia, G. Tags: Airway pharmacology and treatment Source Type: research

Analysis of two-year treatment with omalizumab patients with severe asthma in real clinical practice
Objective: to evaluate the clinical efficacy and safety of long-term anti-IgE therapy patients with severe uncontrolled asthma.Materials and Methods: in Chelyabinsk city from November 2016 35 patients regularly receive omalizumab therapy - 9 men (26%) and 26 women (74%), the average age 44.5±14.1 years, the duration of asthma - 25.2±11.5 years. All patients had allergic pathology: allergic rhinitis - 100%, pollinosis - 79.4%, food allergy - 44.1%, atopic dermatitis - 26.5%. The level of total IgE in the blood is from 72 to 787 IU/ml, high sesitization to household (88.6%), epidermal (62.9%), pollen (74.3%) al...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Blinova, E., Ignatova, G. Tags: Airway pharmacology and treatment Source Type: research

Clinical phenotypes of asthmatics who require long-term use of tiotropium for asthma control: a real-world study
Background: Tiotropium is well tolerated and significantly improve lung function and asthma control as add-on therapy to ICS with or without LABA treatment regardless of baseline characteristics from phase III studies. However, real word studies predicting the long-term need of tiotropium add-on therapy according to clinical phenotypes of asthmatics were limited.Methods: This retrospective study was conducted at a single medical center from July 2016 to July 2018, and used asthma control test (ACT) to evaluate the effectiveness of tiotropium as add-on therapy in uncontrolled asthmatics. We try to identify the subgroups of ...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Cheng, W.-C., Wu, B.-R., Chen, C.-Y., Chen, W.-C., Liao, W.-C., Tu, C.-Y., Chen, C.-H. Tags: Airway pharmacology and treatment Source Type: research

Bidimensional comparative analysis of LABA/LAMA FDCs in COPD
Conclusions: Each currently available LABA/LAMA FDCs has a specific efficacy/safety profile that need to be considered for personalized therapy in COPD. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Rogliani, P., Ora, J., Matera, M. G., Cazzola, M., Calzetta, L. Tags: Airway pharmacology and treatment Source Type: research

Novel lung function tests can improve phenotyping and differential therapy in COPD
Conclusion: IOS and MBW add information to current diagnostic concepts in COPD. Initial phenotyping is improved and consequences for differential therapy can be derived. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Trinkmann, F., Gawlitza, J., Schäfer, J., Schroeter, M., Drayss, J., Michels, J., Borggrefe, M., Akin, I., Saur, J. Tags: Airway pharmacology and treatment Source Type: research

Benefits of tiotropium/olodaterol compared with tiotropium in patients with COPD receiving only LAMA at baseline: pooled analysis of 4 clinical trials
Background: TONADO and OTEMTO were large, randomised, double-blind, Phase III trials that demonstrated the efficacy of tiotropium/olodaterol (T/O) compared with tiotropium (tio) in COPD.Aim: We pooled data from TONADO and OTEMTO to investigate the effect on symptoms and lung function of stepping up treatment from tio to T/O in patients who received only tio at baseline.Methods: TONADO 1+2 (NCT01431274/NCT01431287) were 52-week studies and OTEMTO 1+2 (NCT01964352/NCT02006732) were 12-week studies in patients with COPD with FEV1
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Buhl, R., Singh, D., De La Hoz, A., Voss, F., Ferguson, G. T. Tags: Airway pharmacology and treatment Source Type: research

Effects of combined tiotropium/olodaterol on dynamic lung hyperinflation evaluated by the incremental hyperventilation method
Conclusions: Combined tiotropium/olodaterol (Respimat®) may improve DLH and exercise performance in addition to increasing FEV1 and health status in COPD. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Kawachi, S., Fujimoto, K. Tags: Airway pharmacology and treatment Source Type: research

Difficult-to-treat asthma : a multidimensional approach before considering targeted therapy
Poor control in patients with difficult-to-treat asthma might be due to several factors, including poor adherence and undertreated asthma co-morbidities. After an assessment addressing these issues, only few patients still need targeted therapy.We aimed to evaluate the effect of a multidimensional intervention in improvement asthma control in patients with difficult asthma.Fifty patients with difficult asthma were prospectively included in this study conducted in AbderrahmenMami hospital between March 2018 and September 2018. Clinical, biological and functional characteristics were collected. Then, coexisting conditions (p...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Louhaichi, S., Hamdi, B., Khalfallah, I., Akkad, A., Ammar, J., Berraies, A., Hamzaoui, A. Tags: Airway pharmacology and treatment Source Type: research