The effect of inhaled tiotropium bromide on lung mucociliary clearance in patients with COPD

Chest. 2004 May;125(5):1726-34. doi: 10.1378/chest.125.5.1726.


Study objective: To assess the effects of tiotropium on lung mucociliary clearance in COPD.

Design: Randomized, double-blind, placebo-controlled, parallel-group study.

Setting: Outpatients of an urban-area university teaching hospital.

Patients: Thirty-four patients with COPD aged 40 to 75 years classified equally into two groups.

Intervention: Single (18 microg) daily dose of tiotropium inhalation capsules or of placebo for 21 days.

Methods: Six-hour tracheobronchial clearance of inhaled 99mTc-labeled polystyrene particles using a 48-h retention measurement to determine the "nontracheobronchial" deposition fraction.

Results: Test radioaerosol penetration into the lungs increased significantly (p < 0.003) as did FEV1 (p < 0.006) in the tiotropium-treated patients, but measured mucociliary clearance was not significantly changed despite the increased pathway length for clearance (mean +/- SE area under the tracheobronchial retention curve changed from 442 +/- 22 to 453 +/- 20%/h). Smaller (nonsignificant) decreases of radioaerosol penetration and FEV1 occurred in the placebo group together with a small (nonsignificant) decrease in the area under the retention curve.

Conclusion: Twenty-one days of inhaled tiotropium, 18 microg/d, as a dry powder does not retard mucus clearance from the lungs.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / pharmacology*
  • Bronchodilator Agents / therapeutic use
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mucociliary Clearance / drug effects*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Scopolamine Derivatives / administration & dosage
  • Scopolamine Derivatives / pharmacology*
  • Scopolamine Derivatives / therapeutic use
  • Tiotropium Bromide


  • Bronchodilator Agents
  • Scopolamine Derivatives
  • Tiotropium Bromide