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Abstract: Poster Presentations |

LUNG FUNCTION IMPROVEMENTS WITH TIOTROPIUM BROMIDE IN CONSTRICTIVE BRONCHIOLITIS FREE TO VIEW

Ronaldo A. Kairalla, MD*; Marcelo J. Rocha, MD; Carlos R. Carvalho, MD
Author and Funding Information

Pulmonary Division-Heart Institution (InCor), University of São Paulo, Medical, São Paulo, Brazil


Chest


Chest. 2005;128(4_MeetingAbstracts):315S. doi:10.1378/chest.128.4_MeetingAbstracts.315S-a
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Abstract

PURPOSE:  Constrictive bronchiolitis is characterized by a fibrosing inflammatory process that surrounds rather than fills airways lumen, resulting in hyperinsufflation. HRCT demonstrates mosaic areas of decreased attenuation and vascularity and evidence of air-trapping. The disease is poorly responsive to steroids and adrenergics bronchodilators. Tiotropium bromide is a synthetic quaternary anticholinergic agent that is functionally selective for specific muscarinic receptors that mediate airway smooth-muscle contraction, and has an extremely long duration of action.

METHODS:  Six patients, 3 female, mean age 54.8y (±8.7)nonsmonkers, with clinical, HRCT and functional diagnosis of constrictive bronchiolitis, with lung biopsy in 4, were submitted to a trial of once-daily inhalation of tiotropium (18 mcg).

RESULTS:  Spirometry was performed before and 21 days after the medicationThe initial spirometry showed a an obstructive pattern (mean±SD): FVC=1.3±0.3L and FEV1=0.74±0.3L. After 21 days of tiotropium, in all patients the FVC improve more than 10%. Mean FVC also significatively improve (1.65±0.4, p=0.004), but not the FEV1 (0.91±0.4).

CONCLUSION:  In spite of fibrosing predominance in constrictive bronchiolitis, we observed a significant improvement of pulmonary function after 21 days of tiotropium.

CLINICAL IMPLICATIONS:  The influence of this finding on the evolution of the disease needs further investigation.

DISCLOSURE:  Ronaldo Kairalla, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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