The Effect of Tiotropium on Hyperinflation and Exercise Capacity in Chronic Obstructive Pulmonary DiseaseVerkindre C.a · Bart F.a · Aguilaniu B.b · Fortin F.c · Guérin J.-C.d · Le Merre C.e · Iacono P.f · Huchon G.g
aCentre Hospitalier Germon et Gauthier, Béthune, bHYLAB Laboratoire de Physiologie Clinique, Grenoble, cCLEFAR, Clinique de la Louvière, Lille, dHôpital Croix Rousse, Lyon, eCHR, Service de Pneumologie, Médecine Interne A, Nîmes, fBoehringer Ingelheim France, Reims, et gPneumologie et Réanimation Hôtel-Dieu, Paris, France
Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation, which results in the progressive development of dyspnea and exercise limitation. Objective and Methods: To compare the effect of tiotropium with placebo on forced vital capacity (FVC) in patients with moderate-to-severe COPD and lung hyperinflation, using exercise endurance, dyspnea and health-related quality of life (HRQoL) as secondary endpoints. One hundred patients were randomized to receive either tiotropium 18 µg once daily or placebo for 12 weeks. Results: Trough (predose) FVC was significantly improved with tiotropium compared to placebo on day 42 (0.27 ± 0.08 liters) and 84 (0.20 ± 0.08 liters; p < 0.05 for both). Trough inspiratory capacity (IC) was also significantly improved with tiotropium compared to placebo on day 42 (0.16 ± 0.07 liters) and 84 (0.15 ± 0.07 liters; p < 0.05 for both). Tiotropium increased the mean distance walked during the shuttle walking test by 33 ± 12 (day 42) and 36 ± 14 m (day 84) compared to placebo (p < 0.05 for both). On day 84, 59% of the patients in the tiotropium group and 35% of the patients in the placebo group had significant and clinically meaningful improvements in the St. George’s Respiratory Questionnaire total score (p < 0.05). Numerical decreases in the focal score in the Transition Dyspnea Index in patients receiving tiotropium versus placebo suggest that tiotropium also improved dyspnea during activities of daily living. Conclusion: Tiotropium 18 µg once daily reduced hyperinflation with consequent improvements in walking distance and HRQoL in patients with COPD and lung hyperinflation.
© 2006 S. Karger AG, Basel
Lead Investigators and Participating Centers: B. Aguilaniu, UCPX, Laboratoire de Physiopathologie de l’Exercice, Grenoble; F. Bart, Centre Hospitalier Germon et Gauthier, Béthune; D. Caillaud, CHU, Hôpital Gabriel Montpied, Service de Pneumologie, Clermont- Ferrand; F. Fortin, CLEFAR, Clinique de la Louvière, Lille; H. Guenard, Centre François Magendi, Hôpital de Haut Lévêque, Pessac; J.-C. Guérin, Hôpital Croix Rousse, Lyon; C. Le Merre, CHR, Hôpital Gaston Doumergue, Service de Pneumologie, Médecine Interne A, Nîmes; G. Huchon, Pneumologie et Réanimation Hôtel-Dieu, Paris; J.F. Muir, Centre Hospitalier, Bois Guillaume; B. Wallaert, Hôpital A. Calmette, Département de Pneumologie et Immuno-Allergologie, Lille, France.
Received: January 27, 2005
Accepted after revision: July 20, 2005
Published online: November 7, 2005
Number of Print Pages : 8
Number of Figures : 4, Number of Tables : 3, Number of References : 34
Respiration (International Journal of Thoracic Medicine)
Vol. 73, No. 4, Year 2006 (Cover Date: June 2006)
Journal Editor: Bolliger, C.T. (Cape Town)
ISSN: 0025–7931 (print), 1423–0356 (Online)
For additional information: http://www.karger.com/RES