Three Regimens of Inhaled Bronchodilators for Chronic Obstructive Pulmonary Disease: Comparison of Pulmonary Function and Cardiopulmonary Exercise Test Parameters

This study aimed to compare that effects of tiotropium combined with formoterol, ipratropium combined with formoterol and formo- terol alone on cardiopulmonary exercise testing and pulmonary function test parameters in patients with GOLD stage II and III chronic obstructive pulmonary disease (COPD). Thirty-seven pati­ents who had been classified according to the GOLD as stage II and III participated in this randomized, prospective study. Three groups were created: patients in group 1 (FEVj%: 55.07±9.36%) received tiotropium and formoterol; in group 2 (FEV,%: 50.08±13.87%) they received ipratropium and formoterol, and in group 3 (FEVj%: 62.27±7.34%) they received formoterol alone. Patient demograp­hics were similar among the 3 groups (p>0.05). Prior to treatment, data were recorded for all patients for symptom-limited cycle exer­cise tests and pulmonary function tests. After 28 days of treatment, exercise test and spirometry were repeated, and data regarding the bronchodilator effects of the various treatments were compared. Three treatment regiments of inhaled bronchodilators were compa­red in terms of spirometry and cardiopulmonary exercise test para­meters. Ipratropium combined with formoterol was more effective (Mean percentage changes in FEV]%: 33.30±22.97%) than tiotro­pium combined with formoterol or formoterol alone as a means of improving lung flow in our patients. We found that ipratropium combined with formoterol was superior to tiotropium combined with formoterol and formoterol alone in subjects with stage II and III COPD. We suggest that combining the anticholinergics and Ş- agonists, especially ipratropium combined with formoterol, is more preferable than monotherapy with (3-agonists in these subjects.