What is the difference between ipratropium bromide and tiotropium bromide

References Lee, T. A , Shamrock, G. Arch Intern Med Mac lay, J D, Rabinovich, R. A, Mack, W. Update in Chronic Obstructive Pulmonary Disease Respir, Crit.

Care Med. Journal of pharmaceutical. N Engl. J Med ; Indian 30 an J Med Res. There are new studies which have compared tiotropium with ipratropium bromide, making an update necessary. To compare the relative effects of tiotropium to ipratropium bromide on markers of quality of life, exacerbations, symptoms, lung function and serious adverse events in patients with COPD using available randomised controlled trial RCT data.

We included parallel group RCTs of 12 weeks duration or longer comparing treatment with tiotropium with ipratropium bromide for patients with stable COPD. Two review authors independently assessed studies for inclusion and then extracted data on study quality and outcome results. We contacted trial sponsors for additional information. We analysed the data using Cochrane Review Manager.

This review included two studies of good methodological quality that enrolled participants with COPD. In general, the treatment groups were well matched at baseline but not all outcomes were reported for both studies. Overall the risk of bias across the included RCTs was low. There were fewer people experiencing one or more non-fatal serious adverse events on tiotropium compared to ipratropium odds ratio OR 0. This represents an absolute reduction in risk from to 97 per people over three to 12 months.

Concerning disease specific adverse events, the tiotropium group were also less likely to experience a COPD-related serious adverse event when compared to ipratropium bromide OR 0. For secondary outcomes, both studies reported fewer hospital admissions in the tiotropium group OR 0.

There was no significant difference in mortality between the treatments OR 1. There were fewer participants suffering one of more exacerbations in the tiotropium arm OR 0. Patients with known active tuberculosis. Patients with a history of cancer within the last five years. Patients with treated basal cell carcinoma are allowed. Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or bronchiectasis.

Patients who have undergone pulmonary resection or a thoracotomy for any reason. Patients with known hypersensitivity to anticholinergic drugs, lactose or any other component of the inhalation capsule delivery system or the MDI Patients with known symptomatic prostatic hypertrophy or bladder neck obstruction. Patients with known narrow-angle glaucoma. Patients who are being treated with cromolyn sodium or nedocromil sodium.

Patients who are being treated with antihistamines. Patients using oral corticosteroid medication at unstable i. Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception e. A repeat eosinophil count will not be conducted in these patients.

Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials. Paul's Hospital, Dept. Korea Ltd. More Information. Additional Information: Related Info. National Library of Medicine U. National Institutes of Health U.

Department of Health and Human Services. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Pulmonary Disease, Chronic Obstructive.