For patients with COPD, tiotropium has many benefits

 For patients with COPD, tiotropium has many benefits

According to the German Institute for Quality and Efficiency in Health Care (IQWiG), tiotroprium bromide is one of the drugs of choice for patients with COPD. This drug seems to have many advantages both in terms of symptoms and in terms of quality of life. The researchers reached these conclusions after analysing many studies that have compared tiotropium with others drugs.

Tiotropium is an anticholinergic drug that is used for the treatment of COPD, a chronic disease that includes chronic bronchitis and emphysema. It works by anticholinergic mechanism, that is it reduces smooth muscle contraction and mucus secretion, with bronchodilator effect.

Patients with COPD

COPD is a respiratory disease that is characterized by airway narrowing that occurs due to a chronic inflammatory process and excess mucus secretion. There are two types of COPD: emphysema, that is mainly manifested by dyspnea, and chronic bronchitis, where chronic cough is the dominant symptom. Diagnosis is made by spirometry and there are 4 stages of the disease depending on the degree of damage, so treatment should be adapted. It must be noted that COPD is more common than asthma and it affects more men than women. Risk factors for the occurrence of COPD is cigarette smoking, exposure to chemical pollutants in the environment, exposure to passive smoking etc.

Other drugs used to treat COPD, among anticholinergic drugs, are adrenergic bronchodilators (salmeterol, formeterol, salbutamol, etc.), inhaled corticosteroids (budesonide, fluticasone), mast cell stabilizers (nedocromil), leukotriene antagonists (montelukast, zileuton). It should be noted that although COPD is a chronic disease that requires long-term treatment, however, it can be controlled with medication.

According to the IQWiG researchers, tiotropium was shown to have advantages over other placebo drugs. Research has shown that patients who use tiotropium have fewer exacerbations, are hospitalized less, and have a better quality of life. In addition, in terms of daily activity, it seems that tiotropium has an added benefit in this regard.

Also, it seems that tiotropium is more advantageous than salmeterol, formeterol, indacaterol and ipratropium. It was showed that tiotropium is associated with fewer exacerbations and fewer hospitalizations.

10 studies evaluated the difference between tiotropium and other drugs such as ipratropium, the combination of salmeterol and fluticasone and the group of drugs known as “LABA”. The report showed that there is a benefit of tiotropium in terms of exacerbations and symptoms of COPD.

It should be noted that no differences were found regarding mortality, exercise capacity, cardiovascular diseases or side effects between tiotropium and other drugs investigated. Side effects of this drug are related to antimuscarinic effects, that is dry mouth, urinary retention, constipation, heart arrhythmias, glaucoma, etc..