Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 4

Sequential comparison of tiotropium to high-dose ipratropium in patients with chronic obstructive pulmonary disease in a practice setting

Authors Gauhar U, Dransfield M, Cooper A

Published 14 October 2009 Volume 2009:4 Pages 391—395


Review by Single-blind

Peer reviewer comments 3

Umair Gauhar, Mark Dransfield, J Allen D Cooper

Pulmonary Section, Birmingham Veterans Affairs Medical Center and Division of Allergy, Pulmonary and Critical Medicine University of Alabama at Birmingham, AL, USA

Objective: To determine the effect of changing anticholinergic therapy in patients with COPD from ipratropium to tiotropium on pulmonary function.

Methods: We examined records of patients prescribed high-dose ipratropium, who were subsequently converted to tiotropium. Spirometric values were obtained within 2 days of the change in medication and after 56 to 224 days of the switch to tiotropium.

Results: 15 subjects were documented to have filled a prescription for ipratropium-containing medications the month prior to the change. Medication compliance over the 6 months prior to the switch in these patients was 72% ± 31% (mean ± SD) for ipratropium compared to 87% ± 14% for tiotropium over the 6-month period after the switch (P = 0.1). FEV1 improved from 1.12 ± 0.39 L at baseline to 1.37 ± 0.49 L after the change to tiotropium (P = 0.01). FVC also improved from 2.45 ± 0.73 L at baseline to 2.72 ± 0.69 L after the change (P = 0.04). Maximal voluntary ventilation was also increased from 39.67 ± 10.7 L/min to 45.13 ± 15.8 L/min (P = 0.045).

Conclusions: We conclude that replacing high-dose ipratropium with tiotropium therapy significantly improves pulmonary function in a clinical setting.

Keywords: ipratropium, tiotropium, COPD, pulmonary function, exacerbation rate

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 


Readers of this article also read:

Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients

Nascimento ESP, Sampaio LMM, Peixoto-Souza FS, Dias FD, Gomes ELFD, Greiffo FR, Ligeiro de Oliveira AP, Stirbulov R, Vieira RP, Costa D

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:645-653

Published Date: 23 March 2015

Accessing to the minor proteome of red blood cells through the influence of the nanoparticle surface properties on the corona composition

Zaccaria A, Roux-Dalvai F, Bouamrani A, Mombrun A, Mossuz P, Monsarrat B, Berger F

International Journal of Nanomedicine 2015, 10:1869-1883

Published Date: 9 March 2015

Therapeutic inhibition of prolyl hydroxylase domain-containing enzymes in surgery: putative applications and challenges

Harnoss JM, Strowitzki MJ, Radhakrishnan P, Platzer LK, Harnoss JC, Hank T, Cai J, Ulrich A, Schneider M

Hypoxia 2015, 3:1-14

Published Date: 30 January 2015

Central airways remodeling in COPD patients

Pini L, Pinelli V, Modina D, Bezzi M, Tiberio L, Tantucci C

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:927-933

Published Date: 1 September 2014

Primary care physician perceptions on the diagnosis and management of chronic obstructive pulmonary disease in diverse regions of the world

Aisanov Z, Bai CX, Bauerle O, Colodenco FD, Feldman C, Hashimoto S, Jardim J, Lai CKW, Laniado-Laborin R, Nadeau G, Sayiner A, Shim JJ, Tsai YH, Walters RD, Waterer G

International Journal of Chronic Obstructive Pulmonary Disease 2012, 7:271-282

Published Date: 5 April 2012

Beta-blockers and health-related quality of life in patients with peripheral arterial disease and COPD

Yvette RBM van Gestel, Sanne E Hoeks, Don D Sin, Henk Stam, Frans W Mertens, Jeroen J Bax, Ron T van Domburg, Don Poldermans

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:177-183

Published Date: 8 May 2009