Title: A literature review examining the use of the combination inhaler tiotropium/olodaterol in COPD
Project Advisors: Dr. Alexa Carlson, PharmD; Dr. Tayla Rose, PharmD
Student: Lauren Motto
Objectives: To evaluate the appropriate use of Stiolto™ Respimat® (tiotropium/olodaterol) in chronic obstructive pulmonary disease (COPD) based upon pharmacokinetic and clinical trial data to determine adverse events and drug interactions as well as discuss dosage, administration, and formulary considerations of this combination inhaler.
Methods: A total of 15 randomized control trials, literature reviews, analyses, and ongoing trials were found using PubMed, Clinical Key, ClinicalTrials.gov, and tiotropium/olodaterol's website. Clinical trials comparing tiotropium/olodaterol to other medications in similar drug classes and monitoring the inhaler for safety were included. Opinion articles were excluded.
Results: The tiotropium/olodaterol inhaler dosed at 5mcg/5mcg demonstrated increased forced expiratory volume in 1 second (FEV1), trough FEV1, and quality of life (QOL) with minimally increased incidence of adverse effects compared to monotherapy inhalers in the same drug class. Evidence suggests the use of tiotropium/olodaterol may be preferred in place of monotherapy for patients with moderate to very severe COPD. Currently evidence is lacking in terms of the inhaler's effects on cardiac and renal function; however ongoing research shows no increase in cardiovascular or renal risk.
Conclusions: Early results of post-marketing research indicate tiotropium/olodaterol is safe and offers improved efficacy as a combination agent compared to similar inhalers. The combination therapy has beneficial advantages and has been successful at treating moderate to very severe COPD.