In patients with COPD, treatment with a combination of formoterol and ipratropium is more effective than a combination of salbutamol and ipratropium: A 3-week, randomized, double-blind, within-patient, multicenter study
Articolo
Data di Pubblicazione:
2001
Citazione:
In patients with COPD, treatment with a combination of formoterol and ipratropium is more effective than a combination of salbutamol and ipratropium: A 3-week, randomized, double-blind, within-patient, multicenter study / A.D. D'urzo, M.C. De Salvo, A. Ramirez-Rivera, J. Almeida, L. Sichletidis, G. Rapatz, J. Kottakis, J. Almeida, S. Boucher, J. Castillo, S. Centanni, J. Cordoso, M.C. De Salvo, C.G. Di Bartolo, A. D'urzo, A. Eivindson, D. Gorecka, C. Gratziou, J. Kottakis, J. Kozielski, G. Krammer, K.E. Langaker, S. Boucher, M.-. Lindor, R. Maleki-Yazdi, J.R. Manzano, P. Patel, A.M. Perez, P. Pfister, A. Ramirez-Rivera, G. Rapatz, K. Rimmer, N. Ringdal, M.A. Salazar, E. Barbeta Sanchez, J. Moutinho dos Santos, L. Sichletidis. - In: CHEST. - ISSN 0012-3692. - 119:5(2001), pp. 1347-1356. [10.1378/chest.119.5.1347]
Abstract:
Study objectives: To compare the efficacy of adding formoterol or salbutamol to regular ipratropium bromide treatment in COPD patients whose conditions were suboptimally controlled with ipratropium bromide alone. Design: A randomized, double-blind, double-dummy, two-period, crossover clinical trial. Setting: Twenty-four clinics and university medical centers in nine countries. Patients: One hundred seventy-two patients with baseline FEV1 ≥ 65% predicted, with FEV1 reversibility to salbutamol not exceeding the normal variability of the measurement, and symptomatic despite regular treatment with ipratropium bromide. Interventions: Each patient received two treatments in random order: either inhaled formoterol dry powder, 12 μg bid, in addition to ipratropium bromide, 40 μg qid for 3 weeks, followed by salbutamol, 200 μg qid, in addition to ipratropium, 40 μg qid for 3 weeks, or vice versa. Measurements and results: Efficacy end points included morning premedication peak expiratory flow (PEF) during the last week of treatment (primary end point), the area under the curve (AUC) for FEV1 measured for 6 h after morning dose on the last day of treatment, and symptom scores (from daily diary recordings). Morning PEF and the AUC for FEV1 were significantly better for formoterol/ipratropium than for salbutamol/ipratropium (p = 0.0003 and p > 0.0001, respectively). The formoterol/ipratropium combination also induced a greater improvement in mean total symptom scores (p = 0.0042). The safety profile of the two treatments was comparable. Conclusions: In COPD patients requiring combination bronchodilator treatment, the addition of formoterol to regular ipratropium treatment is more effective than the addition of salbutamol.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
beta(2)-agonist; COPD; formoterol; ipratropium; salbutamol
Elenco autori:
A.D. D'Urzo, M.C. De Salvo, A. Ramirez-Rivera, J. Almeida, L. Sichletidis, G. Rapatz, J. Kottakis, J. Almeida, S. Boucher, J. Castillo, S. Centanni, J. Cordoso, M.C. De Salvo, C.G. Di Bartolo, A. D'Urzo, A. Eivindson, D. Gorecka, C. Gratziou, J. Kottakis, J. Kozielski, G. Krammer, K.E. Langaker, S. Boucher, M.-. Lindor, R. Maleki-Yazdi, J.R. Manzano, P. Patel, A.M. Perez, P. Pfister, A. Ramirez-Rivera, G. Rapatz, K. Rimmer, N. Ringdal, M.A. Salazar, E. Barbeta Sanchez, J. Moutinho dos Santos, L. Sichletidis
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