Bronchodilating effect of oxitropium bromide in heart disease patients with exacerbations of COPD: Double-blind, randomized, controlled study

Anti-cholinergic agents are considered the bronchodilator therapy of first-choice in the treatment of patients with stable chronic obstructive pulmonary disease (COPD) associated with heart disease since they may be as effective or more effective than inhaled β₂-agonists and, moreover, they do not interact with cardiac β-adrenoceptors. The aim of our study was to evaluate the bronchodilator activity of oxitropium bromide in outpatients suffering from exacerbations of COPD associated with heart diseases (ischaemic heart disease and/or arrhythmias).We recruited 50 consecutive outpatients (33 males and 17 females, mean age 68.6 years, 15 current smokers and 35 ex-smokers). Each patient performed body plethismography in basal condition and 30 min after inhalation of 200 μg metered dose inhaler (MDI) oxitropium bromide administered by a device (Fluspacer®), FEV₁, FVC, MMEF_25.75, sRaw and tRaw were evaluated. Thirty minutes after 200 μg oxitropium bromide administration, we observed a significant improvement in FEV₁ 11.6% ± 1 (mean ± SEM) (P <0.01); FVC, MMEF_25.75 sRaw variation was respectively: 9.2% ± 0.6, 31.4 ± 2.9, -19.9 ± 1.1. Placebo did not significantly change pulmonary function. Our data suggest that oxitropium bromide bronchodilator activity is effective in exacerbations of COPD.