Combination of thiotropium bromide with almitrine and pulmonary rehabilitation in the treatment of patients with chronic obstructive pulmonary disease

• Published in: Terapevtic̆eskii arhiv Vol. 80; no. 3; p. 28
• Main Authors: Titova, O N, Ignat'ev, V A, Didur, M D, Kameneva, M Iu, Sukhovskaia, O A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2008
• Subjects: Administration, Inhalation; Almitrine - administration & dosage; Bronchodilator Agents - administration & dosage; Dose-Response Relationship, Drug; Drug Therapy, Combination; Exercise Therapy - methods; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - rehabilitation; Quality of Life; Scopolamine Derivatives - administration & dosage; Tiotropium Bromide; Treatment Outcome
• ISSN: 0040-3660

To elucidate efficacy of a combination almitrine+thiotropium bromide (TB)+pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) of stage II-III complicated with chronic respiratory failure (CRF).
Efficacy of therapy was compared in two groups of patients: group 1 (n = 22) received TB in a dose 18 mcg/day for one year, almitrine in a dose 10 mg/kg/day for 3 months, an 8 week course of PR, group 2 (n = 17) received TB and PR. The treatment efficacy was determined by spirometric parameters of external respiration function, blood gases, dyspnea indices, exercise tolerance assessed by 6-min walk test, quality of life (St. George Hospital Respiratory Questionnaire).
Group 1 patients walked longer distance after a course of PR and 1 year later (by 90.5 +/- 25.4 and 44.5 +/- 10.2 m, respectively, p < 0.05), had reduced desaturation measured by pulsoxym-etry at the end of 6-min walk test, increased PaO2 in baseline under 70 mmHg (by 5.8 +/- 1.2 mmHg, p > 0.05), decreased exacerbation rate per 1 patient a year (by 25%).
Combination treatment with TB, almitrine and PR is indicated for COPD patients with moderate hypoxemia.