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Long-acting anticholinergic agents in patients with uncontrolled asthma: A systematic review and meta-analysis

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 
Citation
 INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol.18(12) : 1421-1430, 2014 
Journal Title
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
ISSN
 1027-3719 
Issue Date
2014
MeSH
Anti-Asthmatic Agents/adverse effects ; Anti-Asthmatic Agents/therapeutic use* ; Asthma/diagnosis ; Asthma/drug therapy* ; Asthma/physiopathology ; Bronchodilator Agents/adverse effects ; Bronchodilator Agents/therapeutic use* ; Chi-Square Distribution ; Cholinergic Antagonists/adverse effects ; Cholinergic Antagonists/therapeutic use* ; Drug Therapy, Combination ; Forced Expiratory Volume ; Humans ; Lung/drug effects* ; Lung/physiopathology ; Odds Ratio ; Quality of Life ; Randomized Controlled Trials as Topic ; Scopolamine Derivatives/adverse effects ; Scopolamine Derivatives/therapeutic use* ; Severity of Illness Index ; Tiotropium Bromide ; Treatment Outcome
Keywords
asthma ; tiotropium ; anticholinergics
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.
Full Text
http://www.ingentaconnect.com/content/iuatld/ijtld/2014/00000018/00000012/art00008
DOI
10.5588/ijtld.14.0275
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138269
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