Trial reportThe Journal of allergy and clinical immunology2013
Predictors of response to tiotropium versus salmeterol in asthmatic adults.
Trial report in The Journal of allergy and clinical immunology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00565266 (Asthma Clinical Research Network), which is not on this map. Cited by 36 papers, 4 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)
Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Effectiveness and tolerability of dual and triple combination inhaler therapies compared with each other and varying doses of inhaled corticosteroids in adolescents and adults with asthma: a systematic review and network meta-analysis.The Cochrane database of systematic reviews · 2022Pooled 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 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
- Biomarkers to Predict Response to Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists in Adolescents and Adults with Mild Persistent Asthma.Annals of the American Thoracic Society · 2022Trial
- Dysanapsis and the Spirometric Response to Inhaled Bronchodilators.American journal of respiratory and critical care medicine · 2021Trial
- Determinants of response to inhaled extrafine triple therapy in asthma: analyses of TRIMARAN and TRIGGER.Respiratory research · 2020Trial
- A randomised controlled trial of tiotropium in adolescents with severe symptomatic asthma.The European respiratory journal · 2017Trial
- Misconceptions of Traits to Predict Response to Inhaled Corticosteroid and Bronchodilator Therapies in Asthma: A Narrative Review.Pulmonary therapy · 2026Review
- Improving asthma outcomes: Clinicians' perspectives on peripheral airways.The journal of allergy and clinical immunology. Global · 2024Article
- Effect of Hyssop (Tanaffos · 2024Article
- Heterogeneity of Treatment Response to Asthma.Advances in experimental medicine and biology · 2023Article
- Clinical predictors of treatment response to tiotropium add-on therapy in adult asthmatic patients: From multicenter real-world cohort data in Korea.The World Allergy Organization journal · 2022Article
- IL-33 receptor inhibition in subjects with uncontrolled asthma: A randomized, placebo-controlled trial.The journal of allergy and clinical immunology. Global · 2022Article
- Residual Dyspnea May Predict Small Airways Dysfunction and Poor Responsiveness to Single-Inhaler Triple Therapy in Asthmatic Patients.Journal of asthma and allergy · 2022Article
- NHLBI ASTHMA NETWORKS: IMPROVING PATIENT CARE, MOVING TOWARD PERSONALIZED MEDICINE.Transactions of the American Clinical and Climatological Association · 2022Article
- Exacerbation-Prone Asthma.The journal of allergy and clinical immunology. In practice · 2020Article
- Clinical predictors of asthmatics in identifying subgroup requiring long-term tiotropium add-on therapy: a real-world study.Journal of thoracic disease · 2019Article
- Airway Innervation and Plasticity in Asthma.Physiology (Bethesda, Md.) · 2019Review
- Future perspectives of anticholinergics for the treatment of asthma in adults and children.Therapeutics and clinical risk management · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
31 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundTiotropium has activity as an asthma controller. However, predictors of a positive response to tiotropium have not been described.
objectiveWe sought to describe individual and differential responses of asthmatic patients to salmeterol and tiotropium when added to an inhaled corticosteroid, as well as predictors of a positive clinical response.
methodsData from the double-blind, 3-way, crossover National Heart, Lung, and Blood Institute's Asthma Clinical Research Network's Tiotropium Bromide as an Alternative to Increased Inhaled Glucocorticoid in Patients Inadequately Controlled on a Lower Dose of Inhaled Corticosteroid (ClinicalTrials.gov number, NCT00565266) trial were analyzed for individual and differential treatment responses to salmeterol and tiotropium and predictors of a positive response to the end points FEV1, morning peak expiratory flow (PEF), and asthma control days (ACDs).
resultsAlthough approximately equal numbers of patients showed a differential response to salmeterol and tiotropium in terms of morning PEF (n = 90 and 78, respectively) and ACDs (n = 49 and 53, respectively), more showed a differential response to tiotropium for FEV1 (n = 104) than salmeterol (n = 62). An acute response to a short-acting bronchodilator, especially albuterol, predicted a positive clinical response to tiotropium for FEV1 (odds ratio, 4.08; 95% CI, 2.00-8.31; P < .001) and morning PEF (odds ratio, 2.12; 95% CI, 1.12-4.01; P = 0.021), as did a decreased FEV1/forced vital capacity ratio (FEV1 response increased 0.39% of baseline for every 1% decrease in FEV1/forced vital capacity ratio). Higher cholinergic tone was also a predictor, whereas ethnicity, sex, atopy, IgE level, sputum eosinophil count, fraction of exhaled nitric oxide, asthma duration, and body mass index were not.
conclusionAlthough these results require confirmation, predictors of a positive clinical response to tiotropium include a positive response to albuterol and airway obstruction, factors that could help identify appropriate patients for this therapy.
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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.