Effects of Tiotropium on Breathing Capacity and Exercise Limitation in Early Stages of Chronic Obstructive Pulmonary Disease

Optimal clinical management in early stages of COPD is not established. Tiotropium has been
shown to improve exercise tolerance during (CWR) cycle ergometry with GOLD stage II to IV
COPD, improvements in constant speed treadmill time in a study of patients who also received
pulmonary rehabilitation in a population of patients with predominantly severe and very
severe disease (GOLD stages III and IV) and improvements in exertional dyspnea, and Shuttle
Walk Test distance in GOLD stage III and IV COPD. However, data are lacking on the benefits
of tiotropium on exercise tolerance in a patients with early stages of COPD who are
symptomatic. Patients with milder ventilatory limitations (GOLD stages I/II COPD patients)
may benefit from maintenance therapy and there is limited data on exercise limitation in
patients with early stage COPD who are symptomatic. This study is designed to evaluate the
mechanisms of breathlessness and assess physical activity limitation in early stage COPD
patients compared to age and gender matched controls and will secondly investigate the
effectiveness of treatment with tiotropium in improving dyspnea during exercise and exercise
duration as a result of the bronchodilation effects of tiotropium leading to a reduction of
dynamic hyperinflation in Early Stage COPD patients.