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Di Marco F, Verga M, Santus P, Morelli N, Cazzola M, Centanni S: Effect of formoterol, tiotropium, and their combination in patients with acute exacerbation of chronic obstructive pulmonary disease: a pilot study.

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Nannini and coworkers found that exacerbations were less frequent with the combinations than with placebo or LABA alone, but not when compared with ICS alone.

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The concurrent administration of other β-mimetics, systemically available anticholinergics and xanthine derivatives (eg, theophylline) may increase the adverse reactions.

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The two trials differed in that the Calverley study involved treatment with prednisone (30 mg OD) and formoterol for 2 wk before randomization and was larger.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Formoterol is indicated for long-term maintenance treatment of asthma in patients with reversible obstructive airway disease, including patients with symptoms of nocturnal asthma, who are using optimal corticosteroid treatment and experiencing regular or frequent breakthrough symptoms requiring regular use of short-acting bronchodilators.

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Analyses of other secondary endpoints supported these results.

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If a face mask is used, care should be taken to avoid leakage around the mask as temporary blurring of vision, pupil enlargement, precipitation or worsening of narrow angle glaucoma, or eye pain may occur if the solution comes into direct contact with the eyes.

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In all cases, there is evidence of improved lung function parameters with the combinations versus monotherapy components.

Recent biopsy evidence of persistent inflammation and obstruction in the small airways of patients with COPD () raises the question of systemic delivery of bronchodilators.

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Comparison of tiotropium once daily, formoterol twice daily and both combined once daily in patients with COPD.

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