Trial reportThe New England journal of medicine2010
Tiotropium bromide step-up therapy for adults with uncontrolled asthma.
Trial report in The New England journal of medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 161 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Asthma Clinical Research Network (ACRN) Trial - Tiotropium Bromide as an Alternative to Increased Inhaled Corticosteroid in Patients Inadequately Controlled on a Lower Dose of Inhaled Corticosteroid (TALC)
Autonomic Nervous System Role in Uncontrolled ASTHMA and the Paucigranulocitic Phenotype
An 8-week, Multicenter, Randomized, Double-blind, Placebo and Active-controlled, Parallel Group, Dose-ranging Study to Evaluate the Efficacy and Safety of 3 Doses of CHF 718 pMDI (HFA Beclomethasone Dipropionate Via Pressured Metered Dose Inhaler) in Asthmatic Subjects.
PrecISE (Precision Interventions for Severe and/or Exacerbation-Prone Asthma) Network Study
Who cites it
161 citing papers in PubMed, 10 syntheses or guidelines pooled it, 510 citations in OpenAlex.
- Addition of long-acting beta2 agonists or long-acting muscarinic antagonists versus doubling the dose of inhaled corticosteroids (ICS) in adolescents and adults with uncontrolled asthma with medium dose ICS: a systematic review and network meta-analysis.The Cochrane database of systematic reviews · 2023Pooled it
- Burden of Asthma and Role of 2.5 µg Tiotropium RespimatAdvances in therapy · 2019Pooled it
- Pooled it
- Pooled it
- Long-acting muscarinic antagonists (LAMA) added to combination long-acting beta2-agonists and inhaled corticosteroids (LABA/ICS) versus LABA/ICS for adults with asthma.The Cochrane database of systematic reviews · 2016Pooled it
- Long-acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus the same dose of ICS alone for adults with asthma.The Cochrane database of systematic reviews · 2015Pooled it
- Long-acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus higher dose ICS for adults with asthma.The Cochrane database of systematic reviews · 2015Pooled it
- Long-acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus addition of long-acting beta2-agonists (LABA) for adults with asthma.The Cochrane database of systematic reviews · 2015Pooled it
- Combination inhaled steroid and long-acting beta2-agonist versus tiotropium for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2013Pooled it
- [Spanish COPD Guidelines (GesEPOC): Pharmacological treatment of stable COPD].Atencion primaria · 2012Guideline
- A phase IIb, randomised, parallel-group study: the efficacy, safety and tolerability of once-daily umeclidinium in patients with asthma receiving inhaled corticosteroids.Respiratory research · 2020Trial
- Exacerbation-prone asthma in the context of race and ancestry in Asthma Clinical Research Network trials.The Journal of allergy and clinical immunology · 2019Trial
- Step-Up Therapy in Black Children and Adults with Poorly Controlled Asthma.The New England journal of medicine · 2019Trial
- Mometasone or Tiotropium in Mild Asthma with a Low Sputum Eosinophil Level.The New England journal of medicine · 2019Trial
- Efficacy and safety of AZD7594, an inhaled non-steroidal selective glucocorticoid receptor modulator, in patients with asthma: a phase 2a randomized, double blind, placebo-controlled crossover trial.Respiratory research · 2019Trial
- Obesity's effect on asthma extends to diagnostic criteria.The Journal of allergy and clinical immunology · 2018Trial
- Therapeutic Effects of a Long-Acting Cholinergic Receptor Blocker, Tiotropium Bromide, on Asthma.Medical science monitor : international medical journal of experimental and clinical research · 2018Trial
- Race is associated with differences in airway inflammation in patients with asthma.The Journal of allergy and clinical immunology · 2017Trial
- Population Pharmacokinetics Modeling of Inhaled Umeclidinium for Adult Patients with Asthma.European journal of drug metabolism and pharmacokinetics · 2017Trial
- Efficacy and safety of ipratropium bromide/albuterol compared with albuterol in patients with moderate-to-severe asthma: a randomized controlled trial.BMC pulmonary medicine · 2016Trial
101 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
34 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundLong-acting beta-agonist (LABA) therapy improves symptoms in patients whose asthma is poorly controlled by an inhaled glucocorticoid alone. Alternative treatments for adults with uncontrolled asthma are needed.
methodsIn a three-way, double-blind, triple-dummy crossover trial involving 210 patients with asthma, we evaluated the addition of tiotropium bromide (a long-acting anticholinergic agent approved for the treatment of chronic obstructive pulmonary disease but not asthma) to an inhaled glucocorticoid, as compared with a doubling of the dose of the inhaled glucocorticoid (primary superiority comparison) or the addition of the LABA salmeterol (secondary noninferiority comparison).
resultsThe use of tiotropium resulted in a superior primary outcome, as compared with a doubling of the dose of an inhaled glucocorticoid, as assessed by measuring the morning peak expiratory flow (PEF), with a mean difference of 25.8 liters per minute (P<0.001) and superiority in most secondary outcomes, including evening PEF, with a difference of 35.3 liters per minute (P<0.001); the proportion of asthma-control days, with a difference of 0.079 (P=0.01); the forced expiratory volume in 1 second (FEV1) before bronchodilation, with a difference of 0.10 liters (P=0.004); and daily symptom scores, with a difference of -0.11 points (P<0.001). The addition of tiotropium was also noninferior to the addition of salmeterol for all assessed outcomes and increased the prebronchodilator FEV1 more than did salmeterol, with a difference of 0.11 liters (P=0.003).
conclusionsWhen added to an inhaled glucocorticoid, tiotropium improved symptoms and lung function in patients with inadequately controlled asthma. Its effects appeared to be equivalent to those with the addition of salmeterol. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT00565266.).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.