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Eguchi and other tests found that tiotropium bromide(136310-93-5) alone 8 weeks can improve COPD patients with FEV1, quality of life (SGRQ scores) and lung hyperplasia. Compared with tiotropium alone, tiotropium + salmeterol improved FEV1 and SGRQ more significantly, but did not further improve lung hyperinflation.

Aaron and colleagues compared the efficacy of tiotropium bromide(136310-93-5), tiotropium + salmeterol, tiotropium + fluticasone + salmeterol in 449 patients with moderate to severe COPD, and the primary end point was deterioration in COPD. As a result, the rate of deterioration was 6218% in tiotropium group, 6418% in tiotropium + salmeterol group, 6018% in tiotropium + fluticasone + salmeterol group. There was no significant difference between the three groups. Compared with the other two groups, tiotropium + fluticasone + salmeterol significantly improved lung function, quality of life and hospitalization rate.

Yokoyama and so on, 61 patients with stable COPD were 12 weeks test, compared the compound group (tiotropium + theophylline) and theophylline unilateral group. The results showed that FEV1 was significantly increased at 4 weeks (1156 ± 0113) L and 8 weeks (1160 ± 0113) L (P <0.01) compared with baseline FEV1 (1140 ± 0112) L, while in the compound group, (P <0.01 and P <0.05) at 4 weeks and 8 weeks, respectively. However, this trial evaluated only the benefit of adding tiotropium in theophylline, but did not evaluate whether tiotropium was required for theophylline. Tashkin et al recently studied whether combi- nation of formoterol and tiotropium in COPD is superior to tiotropium alone. 225 patients with COPD drug treatment for 12 weeks, the morning alone to the morning alone to give 18μg of tiotropium bromide; compound group to give a daily morning 18 μg tiotropium bromide, plus Famoterol 12μg, 2 times a day . The FEV1 value (180 mL) in the compound group was much higher than that in the tiotropium bromide(136310-93-5) group (40 mL) (P <0.01) after 5 min of the first administration. At the end of the trial, FEV1 increased significantly (340 mL) compared with the unilateral group (170 mL) (P <0.01). At the same time, the FEV1 increase in the compound group was much higher than that in the unilateral group (100mL) (P <0.01).

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