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Tiotropium beneficial as add-on for poorly controlled asthma
The use of tiotropium bromide may be beneficial in the treatment of patients with moderate to severe asthma, according to recent study results.
Gustavo J. Rodrigo, MD, of the Hospital Central de las Fuerzas Armadas in Uruguay, and a colleague reviewed 13 randomized controlled trials that included 4,966 patients to assess the efficacy and safety of tiotropium bromide in patients with asthma.
Gustavo J. Rodrigo
The researchers identified studies from the Medline, Embase, CINAHL, Scopus and CENTRAL databases and ClinicalTrials.gov for their meta-analysis.
Ten trials compared patients treated with tiotropium as additional therapy to inhaled corticosteroids (ICS) with those assigned ICS alone for treatment of asthma. The addition of tiotropium improved morning and evening peak expiratory flow (PEF; mean change from baseline, 22 L/minute to 24 L/minute; P < .00001) as well as forced expiratory volume in 1 second (FEV1; P < .00001).
Three of the studies also indicated triple therapy with tiotropium added to twice-daily long-acting beta agonist (LABA) plus ICS benefited patients with severe asthma. The therapy was linked with improvements in morning (mean change, 16 L/minute; P < .0004) and evening PEF (mean change, 20 L/minute; P < .00001). Peak and trough FEV1 also improved (P = .00001).
However, there was not much of a statistical significance when the researchers compared studies assessing tiotropium combined with ICS vs. LABA with ICS.
“This systematic review suggests that tiotropium is noninferior to salmeterol and superior to placebo in patients with moderate to severe asthma who are not adequately controlled by low to moderate ICS or high doses of ICS plus LABA,” the researchers wrote. – by Ryan McDonald
Disclosure: Rodrigo reports he has participated as a lecturer, speaker and adviser in scientific meetings and courses under sponsorship of Air Products & Chemicals; Almirall, SA; AstraZeneca; Boehringer Ingelheim GmbH; Esteve; GlaxoSmithKline; Merck Sharp & Dohme; and Novartis AG. Please see the full study for his colleague’s relevant financial disclosures.