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Abstract

COMPARATIVE STUDY OF TIOTROPIUM AND IPRATROPIUM IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS IN A TERTIARY CARE SOUTH INDIAN TEACHING HOSPITAL

*Reema Thomas, Ramesh Adepu, G. Parthasarathi, Jayaraj B.S and Mahesh PA

ABSTRACT

Objective: To compare the bronchodilator efficacy and safety of tiotropium and ipratropium in patients with Chronic Obstructive Pulmonary Disease (COPD) Methodology: The present study was a prospective randomized study conducted for 12 weeks. Eligible COPD patients were randomized in to two groups to receive either tiotropium 18 mcg once daily via metered dose inhaler (MDI) or ipratropium 40 mcg four times daily via MDI. Lung functions tests, baseline dyspnoea index (BDI) and transition dyspnoea index (TDI), health related quality of life (HRQoL), concomitant use of salbutamol were carried out to assess the lung function. Results: At the end of the study, a total of 70 patients (35 patients in Tiotropium and 35 patients in Ipratropium) completed the study. Both groups showed an improvement in lung functions, HRQoL and dyspnoea indices (p<0.05). Patients in tiotropium group showed a non significant improvement (p>0.05) in lung function compared to ipratropium group. Tiotropium group showed a significant improvement in dyspnoea indices (p<0.05) on 15th day follow-up compared to ipratropium. However, a non significant improvement in HRQoL and dyspnoea scores was observed in both groups. Concomitant use of salbutamol was found lower in the subjects of tiotropium group (p>0.05). Dry mouth was the common adverse effect observed in both groups. Conclusion Tiotropium in a dose of 18 mcg once daily via MDI showed a non significant improvement in dyspnoea, lung functions and all domains of SGRQ compared to ipratropium 40 mcg four times daily.

Keywords: Tiotropium, Ipratropium, COPD, Safety and efficacy, HRQoL.


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