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New Drugs
Men with COPD have a high prevalence of low testosterone levels and dysfunction of the muscles of ambulation, which may contribute to muscle weakness and exercise intolerance. To determine the effect of testosterone supplementation on body composition and muscle function, Casaburi and coworkers performed a randomized, placebo-controlled, 10-week trial in 47 men with COPD (mean FEV1 40% predicted) and low testosterone levels (mean 320 ng/dl). Subjects were randomized to four groups: placebo/no training, testosterone/no training, placebo/resistance training, or testosterone/resistance training. Testosterone injections (100 mg of testosterone enanthate weekly) yielded a mean increase of 271 ng/dl in the nadir serum testosterone concentration. The lean body mass increase averaged 2.3 kg with testosterone alone and 3.3 kg with combined testosterone and resistance training (p < 0.001). Increase in one-repetition maximum leg-press strength averaged 17.2% with testosterone alone, 17.4% with resistance training alone, and 26.8% with testosterone plus resistance training (p < 0.001). These results show that testosterone increases lean body mass and strength in patients with COPD, and that the effect is amplified by concomitant resistance training. The results suggest that testosterone supplementation may be an appropriate therapy, in conjunction with rehabilitative programs, for patients with COPD who have muscle weakness.
Cilomilast is a new selective inhibitor of phosphodiesterase-4. Gamble and coworkers
did a randomized trial of cilomilast (15 mg twice daily) or placebo for 12 weeks in 59 patients with COPD. Cilomilast had no effect on FEV1 or differential cell counts of induced sputum (obtained during five visits). Cilomilast resulted in decreases in CD8+ and CD68+ cells in bronchial biopsies. Compared with placebo, cilomilast produced a 48% decrease in CD8+ cells and a 47% decrease in CD68+ cells. The authors conclude that cilomilast, a selective phosphodiesterase-4 inhibitor, decreases tissue CD8+ T lymphocytes and CD68+ monocytes/macrophages in patients with COPD. An editorial commentary by Kerstjens and Timens
accompanies this article.
Citations 1-3 of 3 total displayed.
Effects of Testosterone and Resistance Training in Men with Chronic Obstructive Pulmonary Disease
- Richard Casaburi, Shalender Bhasin, Louis Cosentino, Janos Porszasz, Attila Somfay, Michael I. Lewis, Mario Fournier, and Thomas W. Storer
Am. J. Respir. Crit. Care Med. 170: 870 -878. First published online as doi:10.1164/rccm.200305-617OC
[Abstract]
[Full text]
Phosphodiesterase 4 Inhibitors: Antiinflammatory Therapy for Chronic Obstructive Pulmonary Disease at Last?
- Huib A.M. Kerstjens and Wim Timens
Am. J. Respir. Crit. Care Med. 168: 914-915.
[Full text]
Antiinflammatory Effects of the Phosphodiesterase-4 Inhibitor Cilomilast (Ariflo) in Chronic Obstructive Pulmonary Disease
- Elizabeth Gamble, Diana C. Grootendorst, Christopher E. Brightling, Susannah Troy, Yusheng Qiu, Jie Zhu, Debbie Parker, Dean Matin, Swati Majumdar, Antonio M. Vignola, Claus Kroegel, Ferran Morell, Trevor T. Hansel, Stephen I. Rennard, Christopher Compton, Ohad Amit, Tri Tat, Jeffrey Edelson, Ian D. Pavord, Klaus F. Rabe, Neil C. Barnes, and Peter K. Jeffery
Am. J. Respir. Crit. Care Med. 168: 976 -982. First published online as doi:10.1164/rccm.200212-1490OC
[Abstract]
[Full text]
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