TY - JOUR T1 - Tiotropium for uncontrolled asthma (a meta-analysis) JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 3542 AU - Manuel Jorge AU - Ralph Elvi Villalobos AU - Marc Gregory Yu AU - Charles Vincent Uy Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/3542.abstract N2 - PURPOSE: The study aims to evaluate the efficacy of tiotropium as an add-on therapy on top of standard controller regimens for the treatment of uncontrolled asthma. Specifically, it aims to evaluate improvement in FEV1 and morning and evening PEF, reduction in exacerbations and use of controller medications, and improvement in quality of life.METHODS: Randomized controlled trials evaluating the efficacy of tiotropium as an add-on therapy for uncontrolled asthma were included in the analysis. A systematic search was performed across electronic databases. Analysis was done using RevMan 5.1 software. Results were presented as mean differences, standard errors, and 95% confidence intervals, and were graphically presented as forest plots.RESULTS: Of the 19 studies retrieved, five were included in the review and totaled 1643 participants. Participants in the tiotropium group had a statistically significant difference in FEV1 improvement (95% CI, 0.14 [0.09, 0.19], p<0.00001), morning PEF improvement (95% CI, 20.03 [11.71, 28.35], p<0.00001), and evening PEF improvement (95% CI, 23.13 [15.18, 31.09], p<0.00001). Among clinical outcomes, there was a trend towards benefit in the reduction of rescue medication use and improvement in quality of life. However, these effects were not statistically significant, (95% CI, 0.12 [-0.17, 0.4], p= 0.42) and (95% CI, 0.1 [-0.05, 0.25], p=0.20) respectively. Homogeneity (I2=0%, Chi2=0.47-3.22) was consistently found across all studies in each of the outcome measures.CONCLUSIONS: Tiotropium, a long-acting anticholinergic, is associated with a statistically significant improvement in pulmonary function in terms of FEV1 and both morning and evening PEF among patients with uncontrolled asthma. ER -