Tiotropium ile kombine tiotropium+formoterol tedavisinin stabil orta-ağır KOAH'lı olgulardaki etkisinin karşılaştırılması
Özet
In recent years, tiotropium bromide treatment is certainly accepted in COPD patients. The aim of this study was to determine the changes on the effect of tiotropium bromide by adding formoterol.33 moderate tosevere stable COPD patients were enrolled in the study with the approval of Local Ethics Committe. 4 patients were excluded as they were unable to perform the spirometric tests. 31of 33 patients were male, and 2 were female. The patients were randomly allocated into two groups; 18 µg Tiotropium+ Placebo (T+P) and 18 µg Tiotropium+ 12 µg Formoterol (T+F). The groups did not differ from each other in respect to age, COPD duration, stage of COPD, and spirometric test results. After a 24 hours wash-out period without any bronchodilator therapy basal spirometric test results (FEV1, FVC, FEV1/FVC, PEF, MMF) were obtained. Thereafter either T+P or T+F in dry powder form was applied to each group. Spirometric tests were repeated at 20 and 120 minutes, 6 and 24 hours. Values were given as percentage of expected. Results were given as mean±SD. As results were not normally distributed nonparametric test (Friedman) was used to compare the results. Then, the significant groups were estimated by multiple comparison test.T+P group showed significant increase in FEV1 at 120 minutes (p<0.05); whereas in T+F group significant rise in FEV1 at 20 minutes, 120 minutes and 6 hours were observed, compared to basal value (p< 0,001) As the two groups were compared in respect to FEV1 changes as to their own basal value, a significant difference at 20 minutes was observed (p< 0.01). FVC values were similar to FEV1. There was a significant rise in PEF value at 20 and 120 minutes in T+F group and at 120 minutes in T+P group as to basal value. For MMF, no significant changes were observed in T+P group; whereas there was a significant rise at 120 minutes in T+F group as to their own basal values.We conclude that bronchodilator effect of combination therapy with tiotropium bromide and formoterol is much more rapid and more effective than tiotropium bromide therapy alone.