Joos G F, Brusselle G, Derom E, Pauwels R
Department of Respiratory Diseases, Ghent University Hospital, Belgium.
Int J Clin Pract. 2003 Dec;57(10):906-9.
Prevention and relief of symptoms by regular use of bronchodilators is central to the management of patients with chronic obstructive pulmonary disease (COPD). The bronchodilators in use are beta2-agonists, anticholinergics and theophylline. Since the 1970s the anticholinergic ipratropium bromide has been widely used for the treatment of patients with regular symptoms, but because it has a relatively short duration of action, it needs to be administered four times a day. Tiotropium bromide is a long-acting anticholinergic suitable for once daily administration. It has been developed as a dry powder inhaler for the treatment of patients with COPD. Large clinical trials with administration of the drug for one year have now been published. Compared with placebo and ipratopium bromide, significant and long-lasting bronchodilatation was observed, which was maintained over the year. The bronchodilator effect of tiotropium bromide was accompanied by improvements in other health outcomes. A significant decrease in dyspnoea, improvement in health-related quality of life, and a reduction in the number of COPD exacerbations and hospitalisations were noted. In this review we summarise the clinical development of this compound.
通过定期使用支气管扩张剂预防和缓解症状是慢性阻塞性肺疾病（COPD）患者管理的核心。目前使用的支气管扩张剂有β2受体激动剂、抗胆碱能药物和茶碱。自20世纪70年代以来，抗胆碱能药物异丙托溴铵已广泛用于治疗有规律症状的患者，但由于其作用持续时间相对较短，需要每天给药4次。噻托溴铵是一种长效抗胆碱能药物，适合每日一次给药。它已被开发为干粉吸入器用于治疗COPD患者。现已发表了该药物给药一年的大型临床试验。与安慰剂和异丙托溴铵相比，观察到显著且持久的支气管扩张作用，且这种作用在一年中持续存在。噻托溴铵的支气管扩张作用还伴随着其他健康结局的改善。观察到呼吸困难显著减轻、健康相关生活质量改善，以及COPD急性加重和住院次数减少。在本综述中，我们总结了该化合物的临床研发情况。
