Am. J. Respir. Crit. Care Med., Volume 161, Number 6, June 2000, 1897-1901

The Effects of Oxitropium Bromide on Exercise Performance in Patients with Stable Chronic Obstructive Pulmonary Disease
A Comparison of Three Different Exercise Tests

TORU OGA, KOICHI NISHIMURA, MITSUHIRO TSUKINO, TAKASHI HAJIRO, AKIHIKO IKEDA, and TAKATERU IZUMI

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

The purpose of the present study was to compare the characteristics of three different exercise tests in evaluating the effects of oxitropium bromide on exercise performance. Thirty-eight males with stable chronic obstructive pulmonary disease (COPD) (FEV₁ = 40.8 ± 16.5% predicted; mean ± SD) completed randomized, double-blind, placebo-controlled, crossover studies for each exercise test. The exercise tests were performed 60 min after the inhalation of either oxitropium bromide 400 µg or placebo. The patients performed 6-min walking tests (6MWT) on Days 1 and 2, progressive cycle ergometry (PCE) on Days 3 and 4, and cycle endurance tests at 80% of the maximal workload of PCE on Days 5 and 6. Spirometry was conducted before and at 45 and 90 min after the inhalation. Oxitropium bromide significantly increased FEV₁ as compared with placebo. Oxitropium bromide increased the endurance time significantly, by 19% (p < 0.001), and caused a small but significant increase in the 6-min walking distance by 1% (p < 0.05), but induced no significant increase in maximal oxygen consumption ( O₂max) in PCE. The responses in these three exercise tests were different, and we conclude that the endurance test was the most sensitive in detecting the effects of inhaled anticholinergic agents on exercise performance in patients with stable COPD. An endurance procedure may be performed to detect clinical changes in evaluating the effects of oxitropium bromide on exercise performance.

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