Vol 80, No 3 (2012)
Review paper
Published online: 2012-05-07
Submitted: 2013-02-22
The influence of treatment with formoterol, formoterol with tiotropium, formoterol with inhaled glucocorticosteroid and tiotropium on lung functions, tolerance of exercise and simple, morning everyday activities in patients with chronic obstructive pulmonary disease (COPD)
Mirosław Szmidt
Pneumonol Alergol Pol 2012;80(3):255-262.
Vol 80, No 3 (2012)
REVIEWS
Published online: 2012-05-07
Submitted: 2013-02-22
Abstract
Bronchodilators — long-acting b2-adrenergic agonists (formoterol and salmeterol) and a long-acting antimuscarinic drug
(tiotropium), are the main drugs applied in symptomatic treatment of COPD. In patients with COPD, dyspnea is frequently
associated with simple everyday activities. Two questionnaires have been published recently as a means of assessing
the patients’ ability to perform morning activities and symptoms. Dynamic hyperinflation is the pathophysiological
disorder responsible for dyspnea and decreased exercise tolerance in COPD. Formoterol is faster than salmeterol in
diminishing air-trapping. It has been shown that treatment with formoterol and tiotropium in COPD patients improves
FEV1, FVC, IC, symptoms score and quality of life in comparison with tiotropium applied alone. Among LABA and inhaled
glucocorticosteroids combinations, those containing formoterol have a more beneficial effect on the ability to perform
simple morning activities (budesonide/formoterol was better than fluticasone/salmeterol). Beclomethasone/formoterol
— 400/24 mcg/die, in comparison with fluticasone/salmeterol — 500/100 mcg/die significantly reduced air-trapping and
dyspnea in COPD patients. The comparison of budesonide/formoterol — 400/12 mcg 2 x die with beclomethasone/
/formoterol — 200/12 mcg 2 x die has shown similar influence of both combinations on FEV1, dyspnea, 6-minute walk
test, symptoms score and quality of life. The addition of budesonide and formoterol combination to tiotropium gives
further benefits: reduces number of exacerbations, improves FEV1, symptoms score and performance of simple morning
routines. Doctors should pay more attention to symptoms and limitations in simple activities in the morning and
adequately adjust the treatment.
Abstract
Bronchodilators — long-acting b2-adrenergic agonists (formoterol and salmeterol) and a long-acting antimuscarinic drug
(tiotropium), are the main drugs applied in symptomatic treatment of COPD. In patients with COPD, dyspnea is frequently
associated with simple everyday activities. Two questionnaires have been published recently as a means of assessing
the patients’ ability to perform morning activities and symptoms. Dynamic hyperinflation is the pathophysiological
disorder responsible for dyspnea and decreased exercise tolerance in COPD. Formoterol is faster than salmeterol in
diminishing air-trapping. It has been shown that treatment with formoterol and tiotropium in COPD patients improves
FEV1, FVC, IC, symptoms score and quality of life in comparison with tiotropium applied alone. Among LABA and inhaled
glucocorticosteroids combinations, those containing formoterol have a more beneficial effect on the ability to perform
simple morning activities (budesonide/formoterol was better than fluticasone/salmeterol). Beclomethasone/formoterol
— 400/24 mcg/die, in comparison with fluticasone/salmeterol — 500/100 mcg/die significantly reduced air-trapping and
dyspnea in COPD patients. The comparison of budesonide/formoterol — 400/12 mcg 2 x die with beclomethasone/
/formoterol — 200/12 mcg 2 x die has shown similar influence of both combinations on FEV1, dyspnea, 6-minute walk
test, symptoms score and quality of life. The addition of budesonide and formoterol combination to tiotropium gives
further benefits: reduces number of exacerbations, improves FEV1, symptoms score and performance of simple morning
routines. Doctors should pay more attention to symptoms and limitations in simple activities in the morning and
adequately adjust the treatment.
Keywords
COPD; morning everyday activities; bronchodilators
Title
The influence of treatment with formoterol, formoterol with tiotropium, formoterol with inhaled glucocorticosteroid and tiotropium on lung functions, tolerance of exercise and simple, morning everyday activities in patients with chronic obstructive pulmonary disease (COPD)
Journal
Advances in Respiratory Medicine
Issue
Vol 80, No 3 (2012)
Article type
Review paper
Pages
255-262
Published online
2012-05-07
Bibliographic record
Pneumonol Alergol Pol 2012;80(3):255-262.
Keywords
COPD
morning everyday activities
bronchodilators