October 2013 Tucson pulmonary journal club: tiotropium Respimat

• Main Authors: Eddib A, Gerald J, Berry C
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2013-11-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: tiotropium; Respimat; Handihaler; dry powder; safety; dysrhythmia; arrthymia; mortality; complication; myocardial infarction
• Online Access: http://www.swjpcc.com/pulmonary-journal-club/2013/11/25/october-2013-tucson-pulmonary-journal-club-tiotropium-respim.html

No abstract available. Article truncated at 150 words. Tiotropium, a long-acting inhaled anticholingeric bronchodilator, is commonly used to prevent COPD exacerbations (1). Tiotropium is available as a dry powder (HandiHaler) or aqueous solution (Respimat). Direct comparisons of the two formulations are lacking. Prior post-hoc analyses suggest that that Respimat may be more efficacious than HandiHaler (2) but it may also increase the risk of death, particularly among those with cardiac dysrhythmias (3-6). The two were recently compared in a large randomized, double-blind, parallel trial of once daily treatment with Respimat (2.5 µg or 5 µg) or HandiHaler (18 µg).[add REF here] Inclusion criteria included a COPD diagnosis, a 10 pack year smoking history, and post-bronchodilator FEV1/FVC ratio ≤ 0.70 and FEV1 ≤ 70% of predicted. Major exclusion criteria included a myocardial infarction within past 6 months, hospitalization for Class III or IV heart failure, or unstable or life-threatening arrhythmia requiring new treatment within the previous 12 months. The …