Authors: Fukuchi, Yoshinosuke¹; Nagai, Atsushi²; Seyama, Kuniaki¹; Nishimura, Masaharu³; Hirata, Kazuto⁴; Kubo, Keishi⁵; Ichinose, Masakazu⁶; Aizawa, Hisamichi⁷; the BAREC Research Group,¹

Source: Treatments in Respiratory Medicine, Volume 4, Number 6, 2005 , pp. 447-455(9)

Publisher: Adis International

Abstract:

Background: Long-acting bronchodilators are recommended for the management of stable COPD to relieve symptoms and improve quality of life. The tulobuterol patch (Hokunalin^®) is a transdermal patch preparation of the β₂-adrenoceptor agonist (β₂-agonist) tulobuterol designed to yield sustained β₂-agonistic effects for 24 hours when applied once daily.

Objective: To compare the effectiveness of tulobuterol patch and inhaled salmeterol (Serevent^® Diskus) in the treatment of stable COPD.

Study design: Clinically stable COPD patients (age ≥40 years, postbronchodilator FEV₁/FVC <70%, and postbronchodilator FEV₁ <80% predicted) were enrolled in a multicenter, open-label randomized study. After a 2-week run-in period, patients were administered either tulobuterol (2mg once-daily applied as a patch) or salmeterol (50μg per inhalation, twice a day) for 12 weeks.

Results: Data for 92 patients (46 each for each treatment group) were analyzed. There were no significant differences in baseline characteristics in the tulobuterol versus salmeterol groups: age, 69.2 ± 7.4 vs 71.6 ± 7.3 years; male, 91% versus 96%; and patients with stage II (III) COPD, 32.6% (67.4%) versus 50% (50%). FEV₁, FVC, and PEF improved during treatment in both groups compared with baseline, with no significant between group differences. The total St George's Respiratory Questionnaire (SGRQ) score was significantly improved relative to baseline in the tulobuterol group at 8 weeks (−4.7 units [U]), but not in the salmeterol group at all timepoints. Domain analysis of the SGRQ scores revealed significant improvement in the symptom score relative to baseline in the tulobuterol group at weeks 4 (−6.9U), 8 (−12.0U), and 12 (−11.7U), but not in the salmeterol group in any of the domains tested. Medical Research Council dyspnea scale score improved during treatment in both groups, with no significant differences between groups. Compliance with the treatment regimen was significantly better in the tulobuterol than in the salmeterol group (98.5% vs 94.1%; p < 0.05).

Conclusion: These findings indicate that once-daily transdermal sustained-release tulobuterol is as effective or better than the inhaled long-acting β₂-agonist salmeterol in the management of stable COPD, with significant effects on quality of life.

Keywords: Chronic obstructive pulmonary disease; Salmeterol; Tulobuterol

Document Type: Research article

Affiliations: 1: 1 Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo, Japan 2: 2 First Department of Medicine, Tokyo Women's Medical University School of Medicine, Shinguku, Tokyo, Japan 3: 3 First Department of Internal Medicine, Hokkaido University, Sapporo, Japan 4: 4 Division of Respiratory Medicine, Osaka City University, Osaka, Japan 5: 5 First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan 6: 6 Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan 7: 7 First Department of Internal Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan

Publication date: 2005-01-01

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• In this Subject: Ear, Nose & Throat ,  Internal Medicine
• By this author: Fukuchi, Yoshinosuke ;  Nagai, Atsushi ;  Seyama, Kuniaki ;  Nishimura, Masaharu ;  Hirata, Kazuto ;  Kubo, Keishi ;  Ichinose, Masakazu ;  Aizawa, Hisamichi ;  the BAREC Research Group,

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