Bronchodilator efficacy of the fixed combination of ipratropium and albuterol compared to albuterol alone in moderate-to-severe persistent asthma

Pulmonary Pharmacology & Therapeutics
Arthur F GelbCraig S Conoscenti

Abstract

The potential of anticholinergics to provide bronchodilatory benefits over short-acting beta(2)-agonists (SABA) alone in patients with moderate-to-severe persistent asthma has not been well defined. An outpatient, randomized, double-blind, single-dose, crossover study in adult asthmatics with moderate-to-severe obstruction despite treatment with inhaled corticosteroids (ICS) was conducted comparing the fixed combination of ipratropium and albuterol (IB+ALB) to albuterol alone (ALB). Serial spirometry was performed over 6h. SABA were withheld for 8h, ICS and LABA for 24h. A total of 113 patients were randomized, 106 completed the study (males n=47; mean+/-SD age=51+/-13 years). Mean+/-SD baseline FEV(1)=1.4+/-0.5 L (49+/-12% predicted). IB+ALB resulted in significantly greater improvements over ALB in the average improvement over baseline in FEV(1) as approximated from the area under the curve from 0 to 6h after drug administration (72 ml, p<0.01) and mean peak FEV(1) response (55 ml, p<0.01) as well as higher FEV(1) responses at individual time points from 0.5 to 6h postdose (p<0.01 for all). Time to onset of response was similar between groups but time to peak and duration of response were longer with IB+ALB versus ALB (120 ve...Continue Reading

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Citations

Oct 7, 2014·Current Allergy and Asthma Reports·Xavier Soler, Joe Ramsdell
Oct 22, 2011·World Journal of Pediatrics : WJP·Xiao-Fang Wang, Jian-Guo Hong
Jul 3, 2010·Journal of Pharmacological and Toxicological Methods·Alexander McNamaraWilliam J Martin
Nov 13, 2009·Medical Hypotheses·Nestor A Molfino
Mar 3, 2011·Allergology International : Official Journal of the Japanese Society of Allergology·Hirofumi KiyokawaMichiaki Mishima
Nov 2, 2013·Clinical Reviews in Allergy & Immunology·T E AlbertsonS Louie
Sep 8, 2010·The New England Journal of Medicine·Stephen C Lazarus
May 18, 2012·The Cochrane Database of Systematic Reviews·Bhupendrasinh F Chauhan, Francine M Ducharme
Nov 22, 2014·Current Opinion in Pulmonary Medicine·Linda Rogers, Nicola A Hanania
Jul 14, 2012·Expert Review of Respiratory Medicine·Federica NovelliPierluigi Paggiaro
Mar 31, 2020·The American Journal of Emergency Medicine·Brit LongMichael Gottlieb

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