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- W2105863984 abstract "<h3>OBJECTIVE:</h3> This meta-analysis was performed to evaluate the efficacy and safety of the addition of tiotropium to standard treatment regimens for inadequately controlled asthma. <h3>METHODS:</h3> A systematic search was made of PubMed, EMBASE, MEDLINE, and CENTRAL databases, and ClinicalTrials.gov, and a hand search of leading respiratory journals. Randomized, double-blind clinical trials on the treatment of inadequately controlled asthma for ≥ 4 weeks with the addition of tiotropium, compared with placebo, were reviewed. Studies were pooled to odds ratio (OR) and weighted mean differences (WMDs), with 95% CI. <h3>RESULTS:</h3> Six trials met the inclusion criteria. The addition of tiotropium, compared with placebo, significantly improved all spirometric indices, including morning and evening peak expiratory flow (WMD 20.59 L/min, 95% CI 15.36–25.81 L/min, <i>P</i> < .001; and WMD 24.95 L/min, 95% CI 19.22–30.69 L/min, <i>P</i> < .001, respectively), trough and peak FEV<sub>1</sub> (WMD 0.13 L, 95% CI 0.09–0.18 L, <i>P</i> < .001; and WMD 0.10 L, 95% CI 0.06–0.14 L, <i>P</i> < .001, respectively), the area under the curve of the first 3 h of FEV<sub>1</sub> (WMD 0.13 L, 95% CI 0.08–0.18 L, <i>P</i> < .001), trough and peak FVC (WMD 0.1 L, 95% CI 0.05–0.15 L, <i>P</i> < .001; and WMD 0.08 L, 95% CI 0.04–0.13 L, <i>P</i> < .001, respectively), the area under the curve of the first 3 h of FVC (WMD 0.11 L, 95% CI 0.06–0.15 L, <i>P</i> < .001). The mean change in the 7-point Asthma Control Questionnaire score (WMD −0.12, 95% CI −0.21 to −0.03, <i>P</i> = .01) was markedly lower in tiotropium group, but not clinically important. There were no significant differences in Asthma Quality of Life Questionnaire score (WMD 0.09, 95% CI −0.01 to 0.20, <i>P</i> = .09), night awakenings (WMD 0.00, 95% CI −0.05 to 0.05, <i>P</i> = .99) or rescue medication use (WMD −0.18, 95% CI −0.36 to 0.00, <i>P</i> = .06). No significant increase was noticed in adverse events in the tiotropium group (OR 0.80, 95% CI 0.62–1.03, <i>P</i> = .08). <h3>CONCLUSIONS:</h3> The addition of tiotropium to standard treatment regimens has significantly improved lung function without increasing adverse events in patients with inadequately controlled asthma. Long-term trials are required to assess the effects of the addition of tiotropium on asthma exacerbations and mortality." @default.
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- W2105863984 date "2013-10-29" @default.
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- W2105863984 title "Tiotropium Versus Placebo for Inadequately Controlled Asthma: A Meta-Analysis" @default.
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- W2105863984 doi "https://doi.org/10.4187/respcare.02703" @default.
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