PMID- 26231467
OWN - NLM
STAT- MEDLINE
DCOM- 20151217
LR  - 20181202
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 115
IP  - 3
DP  - 2015 Sep
TI  - Tiotropium for the treatment of adolescents with moderate to severe symptomatic 
      asthma: a systematic review with meta-analysis.
PG  - 211-6
LID - S1081-1206(15)00445-7 [pii]
LID - 10.1016/j.anai.2015.06.029 [doi]
AB  - BACKGROUND: The role of tiotropium for the treatment of adolescents with asthma 
      has not yet been clearly defined. OBJECTIVE: To assess the efficacy and safety of 
      inhaled tiotropium in adolescents with moderate to severe symptomatic asthma. 
      METHODS: Randomized, placebo-controlled trials were included in this systematic 
      review. Primary outcomes were peak and trough forced expiratory volume in 1 
      second (FEV1). RESULTS: Three studies (approximately 1,000 patients) were 
      included. Tiotropium was associated with significant improvements in FEV1 peak 
      (mean change from baseline) by 120 mL (P < .001) and trough by 100 mL (P < .001) 
      compared with placebo. Tiotropium significantly reduced the percentage of 
      patients who experienced an Asthma Control Questionnaire 7 worsening episode 
      defined as a change from trial baseline of 0.5 points or more compared with 
      placebo (2.1% vs 4.8%, number needed to treat = 38) and also was associated with 
      a significantly decreased in the number of patients with at least one 
      exacerbation compared with placebo (17.6 vs 23.8%, number needed to treat = 16). 
      Finally, no significant differences were found in rescue medication use, 
      withdrawals, withdrawals due to adverse events (AEs), AEs (27.3% vs 27.1%), and 
      serious AEs (6.5% vs 7.1%). Tiotropium in doses of 2.5 mug once daily or 5.0 mug 
      once daily resulted in equivalent effects. CONCLUSIONS: Tiotropium was well 
      tolerated and efficacious as an addition to maintenance treatment with an inhaled 
      corticosteroid or an inhaled corticosteroid plus a long-acting beta-agonist in 
      adolescents with moderate to severe asthma. Available data do not suggest an 
      advantage of the 5-mug once-daily dose (used in adults) compared with the 2.5-mug 
      once-daily dose of tiotropium.
CI  - Copyright (c) 2015 American College of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Rodrigo, Gustavo J
AU  - Rodrigo GJ
AD  - Department of Emergency, Hospital Central de las Fuerzas Armadas, Montevideo, 
      Uruguay. Electronic address: gustavo.javier.rodrigo@gmail.com.
FAU - Castro-Rodriguez, Jose A
AU  - Castro-Rodriguez JA
AD  - Departments of Pediatrics and Family Medicine, School of Medicine, Pontificia 
      Universidad Catolica de Chile, Santiago, Chile.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20150729
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 0 (Bronchodilator Agents)
RN  - XX112XZP0J (Tiotropium Bromide)
SB  - IM
MH  - Adolescent
MH  - Asthma/*drug therapy/pathology
MH  - Bronchodilator Agents/adverse effects/*therapeutic use
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Male
MH  - Respiratory Function Tests
MH  - Surveys and Questionnaires
MH  - Tiotropium Bromide/adverse effects/*therapeutic use
MH  - Treatment Outcome
EDAT- 2015/08/02 06:00
MHDA- 2015/12/19 06:00
CRDT- 2015/08/02 06:00
PHST- 2015/05/21 00:00 [received]
PHST- 2015/06/22 00:00 [revised]
PHST- 2015/06/28 00:00 [accepted]
PHST- 2015/08/02 06:00 [entrez]
PHST- 2015/08/02 06:00 [pubmed]
PHST- 2015/12/19 06:00 [medline]
AID - S1081-1206(15)00445-7 [pii]
AID - 10.1016/j.anai.2015.06.029 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2015 Sep;115(3):211-6. doi: 
      10.1016/j.anai.2015.06.029. Epub 2015 Jul 29.