Tiotropium for the treatment of chronic obstructive pulmonary disease

Abstract

SUMMARY Chronic obstructive pulmonary disease, defined as a partially reversible, progressive airflow obstructive process associated with underlying pulmonary as well as systemic inflammation, is a common disorder and a leading cause of poor health status, medical disability and death. While not curable, the disease is eminently treatable with a variety of pharmacological and nonpharmacological measures. Tiotropium, a long-acting muscarinic receptor antagonist that causes bronchodilation lasting ≥24 h, has been shown, in randomized controlled trials, to produce sustained bronchodilation and reductions in air-trapping and hyperinflation, as well as improvements in patient-reported outcomes, including health-related quality of life, dyspnea, reduced need for rescue medication and reduced risk of exacerbations and hospitalizations for exacerbations. Benefits have been found across the spectrum of disease severity from moderate to very severe. Side effects include those consistent with the drug’s anticholiner...