Abstract | SETTING: A novel effective treatment is necessary for severe asthma. OBJECTIVE: To review clinical trials examining the role of tiotropium in patients with poorly controlled asthma despite inhaled corticosteroid use with or without long-acting β₂-agonists. DESIGN: A computerised search of electronic databases (Medline, EMBASE and Cochrane Central Register) was performed. Randomised controlled trials of at least a 4-week treatment duration with findings published in English were included. RESULTS: Five studies involving 1635 patients were analysed. Compared with a placebo or a double dose of inhaled corticosteroids, the addition of tiotropium increased mean trough and peak forced expiratory volume in 1 second by 97 ml (95%CI 71-122) and 103 ml (95%CI 42-163), respectively. The mean differences in morning peak expiratory flow were 19.2 l/min (95%CI 11.8-26.6). Tiotropium also reduced the risk of severe acute exacerbation (OR 0.73, 95%CI 0.56-0.96) and improved Asthma Quality-of-Life Questionnaire score significantly by 0.10 (95%CI 0.04-0.16). There were no differences in serious adverse events. CONCLUSION: The addition of tiotropium may be beneficial for patients with poorly controlled asthma, although exacerbation or safety issues should be clarified in long-term trials before its wide use in asthma.
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Authors | S W Lee, H J Kim, K H Yoo, Y B Park, J-Y Park, J Y Jung, J-Y Moon, M K Byun, S W Kim, Y H Kim |
Journal | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
(Int J Tuberc Lung Dis)
Vol. 18
Issue 12
Pg. 1421-30
(Dec 2014)
ISSN: 1815-7920 [Electronic] France |
PMID | 25517806
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Chemical References |
- Anti-Asthmatic Agents
- Bronchodilator Agents
- Cholinergic Antagonists
- Scopolamine Derivatives
- Tiotropium Bromide
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Topics |
- Anti-Asthmatic Agents
(adverse effects, therapeutic use)
- Asthma
(diagnosis, drug therapy, physiopathology)
- Bronchodilator Agents
(adverse effects, therapeutic use)
- Chi-Square Distribution
- Cholinergic Antagonists
(adverse effects, therapeutic use)
- Drug Therapy, Combination
- Forced Expiratory Volume
- Humans
- Lung
(drug effects, physiopathology)
- Odds Ratio
- Quality of Life
- Randomized Controlled Trials as Topic
- Scopolamine Derivatives
(adverse effects, therapeutic use)
- Severity of Illness Index
- Tiotropium Bromide
- Treatment Outcome
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