Anti-inflammatory effects of tiotropium in patients with stable COPD

The ANTIOFLAM Study. Investigating anti-inflammatory effect of Tiotropium in COPD

Acetylcholine is the primary parasympathetic neurotransmitter in the airways, and induces bronchoconstriction. Accordingly, treatment with anticholinergics is an effective bronchodilator therapy for COPD.

Recent evidence from animal models of COPD revealed that acetylcholine also promotes airway inflammation, which can be inhibited by anticholinergic intervention. Such an anti-inflammatory effect of anticholinergic intervention could be clinically relevant; however it has not been previously demonstrated in patients with COPD.

Two studies which investigated this have major limitations, mainly because of methodological problems and lack of placebo group. In this study, they hypothesize that tiotropium bromide reduces the ongoing inflammation in patients with COPD compared to placebo. A decrease of leukotriene B4 in sputum after treatment with tiotropium bromide is expected. This will be investigated in a parallel design RCT. Patients will be treated with placebo or tiotropium respimat (5 ug/day) for 6 weeks. They will collect and analyse lung function data (FEV1), questionnaires (CCG/CAT), blood and induced sputum at baseline and after 6 weeks of treatment. Inflammatory markers will be analysed in serum and sputum.

Summary
Acetylcholine is the primary parasympathetic neurotransmitter in the airways, and induces bronchoconstriction. Accordingly, treatment with acetylcholine derivative Tiotropium is an effective bronchodilator therapy for COPD. Recent evidence suggests that Tiotropium may reduce airway inflammation. If true, such an effect could be highly clinically relevant; however it has not been previously demonstrated in patients with COPD. It will now be investigated in a parallel design RCT.
Technology Readiness Level (TRL)
3 - 3
Time period
48 months
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