Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Pulm Pharmacol Ther. 2009 Dec;22(6):533-42. doi: 10.1016/j.pupt.2009.06.002. Epub 2009 Jul 25.
Tiotropium is commonly used in the treatment of chronic obstructive pulmonary disease. Although largely considered to be a long-acting bronchodilator, its demonstrated efficacy in reducing the frequency of exacerbations and preliminary evidence from early studies indicating that it might slow the rate of decline in lung function suggested mechanisms of action in addition to simple bronchodilation. This hypothesis was examined in the recently published UPLIFT study and, although spirometric and other clinical benefits of tiotropium treatment extended to four years, the rate of decline in lung function did not appear to be reduced by the addition of tiotropium in this study. This article summarizes data from a variety of investigations that provide insights into possible mechanisms to account for the effects of tiotropium. The report summarizes the discussion on basic and clinical research in this field.
噻托溴铵常用于治疗慢性阻塞性肺疾病。尽管噻托溴铵通常被认为是一种长效支气管扩张剂，但它在减少恶化频率方面的疗效以及早期研究的初步证据表明，它可能会减缓肺功能下降的速度，这表明除了简单的支气管扩张外，它还有其他作用机制。这一假说在最近发表的 UPLIFT 研究中得到了检验，尽管噻托溴铵治疗在四年内延长了肺功能的改善，但在这项研究中，添加噻托溴铵似乎并没有降低肺功能下降的速度。本文总结了各种研究的数据，这些数据提供了对可能的机制的深入了解，这些机制可以解释噻托溴铵的作用。该报告总结了该领域基础和临床研究的讨论。
