PERF, The Pulmonary Education and Research Foundation, is a small but vigorous non-profit foundation.  We are dedicated to providing help, and general information for those with chronic respiratory disease through education, research, and information.  This publication is one of the ways we do that.  The Second Wind is not intended to be used for, or relied upon, as specific advice in any given case.  Prior to initiating or changing any course of treatment based on the information you find here, it is essential that you consult with your physician.  We hope you find this newsletter of interest and of help

A belated valentine from all of us, to all of you,

 especially long time reader 89 year old "asthmatic Cowboy Ed Smith". We were amused to receive a yellowed newspaper clipping about Spiriva from "Cowboy Ed". He wondered what has happened in the years, and it has been years, since he first read about it. If you receive eNews from PERF, you already know that in January Boehringer Ingelheim Pharmaceuticals, Inc. announced that the United States Food and Drug Administration (FDA) approved Spiriva(®) HandiHaler(®) (tiotropium bromide inhalation powder) for the long-term, once-daily maintenance treatment of bronchospasm associated with Chronic Obstructive Pulmonary Disease (COPD) which includes chronic bronchitis and emphysema. At last! As many of you know, it has been available in Europe and other parts of the world for many months. No one should think that Spiriva is anything like a cure for COPD, but it seems to be a nice addition to the bronchodilator treatments we have at present.

     Spiriva(®), is the first inhaled anticholinergic medication to provide significant and sustained improvements in lung function with once-daily dosing. This drug is closely related to ipratropium bromide (Atrovent), but has a much longer duration of action. Spiriva(®) works through targeting of the primary reversible component of COPD, constriction of the airways, and helps COPD patients breathe easier by opening narrowed airways and helping to keep them open for 24 hours. According to treatment guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), long-acting bronchodilators are the preferred treatment option for COPD maintenance therapy. 

     Spiriva(®) provides significant improvements in key measures of lung function and represents a major advance in the treatment of all stages of COPD," said Dennis E. Doherty, MD, chairman of the National Lung Health Education Program and Professor of Medicine and Chief of the Division of Pulmonary and Critical Care Medicine at the University of Kentucky Medical Center. "Spiriva(®) will become a first-line maintenance treatment for patients with mild to severe COPD. Patients may be able to control their symptoms for a full 24 hours with scheduled once-a-day use."

     As an anticholinergic drug, Spiriva(®) must be used with caution in patients with glaucoma and prostatic hyperplasia, as it occasionally may worsen symptoms of these conditions.

     It will be several more months before it is available in American pharmacies. Be prepared for sticker shock.  Along with the yellowed clipping Ed sent a copy of his autobiography "The Wandering, Trapping and Trading Cowboy" with the inscription "Where trails cross, friends meet". The story of his life on the Dakota Rosebud Indian Reservation, in cow camps, and as a hunter, packer and guide in the far West is a slice of Americana out of the pages of Louis L'Amour. And so is rolling Bull Durhams as a symbol of manhood even when you are a five year old! Marlboro Man, make room for Bull Durham and our own Cowboy Ed!