PMID- 31931792
OWN - NLM
STAT- MEDLINE
DCOM- 20201112
LR  - 20201112
IS  - 1465-993X (Electronic)
IS  - 1465-9921 (Print)
IS  - 1465-9921 (Linking)
VI  - 21
IP  - 1
DP  - 2020 Jan 13
TI  - A comparison of tiotropium, long-acting beta(2)-agonists and leukotriene receptor 
      antagonists on lung function and exacerbations in paediatric patients with 
      asthma.
PG  - 19
LID - 10.1186/s12931-020-1282-9 [doi]
LID - 19
AB  - Diagnosing and treating asthma in paediatric patients remains challenging, with 
      many children and adolescents remaining uncontrolled despite treatment. Selecting 
      the most appropriate pharmacological treatment to add onto inhaled 
      corticosteroids (ICS) in children and adolescents with asthma who remain 
      symptomatic despite ICS can be difficult. This literature review compares the 
      efficacy and safety of long-acting beta(2)-agonists (LABAs), leukotriene receptor 
      antagonists (LTRAs) and long-acting muscarinic antagonists (LAMAs) as add-on 
      treatment to ICS in children and adolescents aged 4-17 years.A literature search 
      identified a total of 29 studies that met the inclusion criteria, including 21 
      randomised controlled trials (RCTs) of LABAs versus placebo, two RCTs of LAMAs 
      (tiotropium) versus placebo, and four RCTs of LTRA (montelukast), all as add-on 
      to ICS. In these studies, tiotropium and LABAs provided greater improvements in 
      lung function than LTRAs, when compared with placebo as add-on to ICS. Although 
      exacerbation data were difficult to interpret, tiotropium reduced the risk of 
      exacerbations requiring oral corticosteroids when added to ICS, with or without 
      additional controllers. LABAs and LTRAs had a comparable risk of asthma 
      exacerbations with placebo when added to ICS. When adverse events (AEs) or 
      serious AEs were analysed, LABAs, montelukast and tiotropium had a comparable 
      safety profile with placebo.In conclusion, this literature review provides an 
      up-to-date overview of the efficacy and safety of LABAs, LTRAs and LAMAs as 
      add-on to ICS in children and adolescents with asthma. Overall, tiotropium and 
      LABAs have similar efficacy, and provide greater improvements in lung function 
      than montelukast as add-on to ICS. All three controller options have comparable 
      safety profiles.
FAU - Vogelberg, Christian
AU  - Vogelberg C
AD  - Department of Pediatric Pulmonology and Allergy, University Hospital Carl Gustav 
      Carus, Technical University of Dresden, Dresden, Germany. 
      christian.vogelberg@uniklinikum-dresden.de.
FAU - Goldstein, Stanley
AU  - Goldstein S
AD  - Allergy and Asthma Care of Long Island, Rockville Centre, New York, USA.
FAU - Graham, LeRoy
AU  - Graham L
AD  - Pediatric Pulmonology, Children's Healthcare of Atlanta, Atlanta, GA, USA.
FAU - Kaplan, Alan
AU  - Kaplan A
AD  - Family Physician Airways Group of Canada, University of Toronto, Toronto, 
      Ontario, Canada.
FAU - de la Hoz, Alberto
AU  - de la Hoz A
AD  - TA Respiratory/Biosimilars Medicine, Boehringer Ingelheim International GmbH, 
      Ingelheim am Rhein, Germany.
FAU - Hamelmann, Eckard
AU  - Hamelmann E
AD  - Klinik fur Kinder und Jugendmedizin, Evangelisches Klinikum Bethel, Bielefeld, 
      and Allergy Center of the Ruhr University, Bochum, Germany.
LA  - eng
GR  - N/A/Boehringer Ingelheim/
PT  - Comparative Study
PT  - Journal Article
PT  - Review
DEP - 20200113
PL  - England
TA  - Respir Res
JT  - Respiratory research
JID - 101090633
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Bronchodilator Agents)
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Leukotriene Antagonists)
RN  - XX112XZP0J (Tiotropium Bromide)
SB  - IM
MH  - Adolescent
MH  - Adrenergic beta-2 Receptor Agonists/*administration & dosage
MH  - Anti-Asthmatic Agents/administration & dosage
MH  - Asthma/diagnosis/*drug therapy/physiopathology
MH  - Bronchodilator Agents/administration & dosage
MH  - Child
MH  - Child, Preschool
MH  - Delayed-Action Preparations/administration & dosage
MH  - *Disease Progression
MH  - Humans
MH  - Leukotriene Antagonists/*administration & dosage
MH  - Lung/drug effects/*physiology
MH  - Randomized Controlled Trials as Topic/methods
MH  - Tiotropium Bromide/*administration & dosage
PMC - PMC6958672
OTO - NOTNLM
OT  - Asthma
OT  - LABA
OT  - LAMA
OT  - LTRA
OT  - Paediatrics
COIS- CV reports personal fees from Allergopharma, ALK, Bencard, Boehringer Ingelheim, 
      Novartis, Stallergenes, Sanofi Avensis, Engelhard and DBV Technology, and grants 
      from the German Society of Research (DFG), outside the submitted work. LG reports 
      personal fees from Boehringer Ingelheim and serves as a speaker and member of the 
      paediatric advisory board for Boehringer Ingelheim outside of the submitted work. 
      AK reports personal fees from Boehringer Ingelheim, Covis, GlaxoSmithKline, Teva, 
      Novartis, Pfizer, AstraZeneca, Purdue, Sanofi, Paladdin and Trudell outside the 
      submitted work. AdlH is an employee of Boehringer Ingelheim. SG and EH have 
      nothing to disclose.
EDAT- 2020/01/15 06:00
MHDA- 2020/11/13 06:00
PMCR- 2020/01/13
CRDT- 2020/01/15 06:00
PHST- 2019/09/09 00:00 [received]
PHST- 2020/01/05 00:00 [accepted]
PHST- 2020/01/15 06:00 [entrez]
PHST- 2020/01/15 06:00 [pubmed]
PHST- 2020/11/13 06:00 [medline]
PHST- 2020/01/13 00:00 [pmc-release]
AID - 10.1186/s12931-020-1282-9 [pii]
AID - 1282 [pii]
AID - 10.1186/s12931-020-1282-9 [doi]
PST - epublish
SO  - Respir Res. 2020 Jan 13;21(1):19. doi: 10.1186/s12931-020-1282-9.