ArticleJournal of asthma and allergy2015
Long-acting muscarinic antagonist use in adults with asthma: real-life prescribing and outcomes of add-on therapy with tiotropium bromide.
Article in Journal of asthma and allergy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Systematic Literature Review of Systemic Corticosteroid Use for Asthma Management.American journal of respiratory and critical care medicine · 2020Pooled it
- Tiotropium treatment for bronchiectasis: a randomised, placebo-controlled, crossover trial.The European respiratory journal · 2022Trial
- Comprehensive Observational Study in a Large Cohort of Asthma Patients after Adding LAMA to ICS/LABA.Pharmaceuticals (Basel, Switzerland) · 2023Article
- The new era of add-on asthma treatments: where do we stand?Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2022Review
- Oral corticosteroid prescription patterns for asthma in France, Germany, Italy and the UK.The European respiratory journal · 2020Article
- Frequency of Tiotropium Bromide Use and Clinical Features of Patients with Severe Asthma in a Real-Life Setting: Data from the Severe Asthma Network in Italy (SANI) Registry.Journal of asthma and allergy · 2020Article
- Barriers to achieving asthma control in adults: evidence for the role of tiotropium in current management strategies.Therapeutics and clinical risk management · 2019Review
- Clinical predictors of the effectiveness of tiotropium in adults with symptomatic asthma: a real-life study.Journal of thoracic disease · 2018Article
- An algorithmic approach for the treatment of severe uncontrolled asthma.ERJ open research · 2018Review
- Tiotropium for the Treatment of Asthma: Patient Selection and Perspectives.Canadian respiratory journal · 2018Review
- Does co-payment for inhaler devices affect therapy adherence and disease outcomes? A historical, matched cohort study.Pragmatic and observational research · 2017Article
- Tiotropium in asthma: back to the future of anticholinergic treatment.Clinical and molecular allergy : CMA · 2017Review
- The evidence on tiotropium bromide in asthma: from the rationale to the bedside.Multidisciplinary respiratory medicine · 2017Review
- Tiotropium in the add-on treatment of asthma in adults: clinical trial evidence and experience.Therapeutic advances in respiratory disease · 2016Review
- Long-Acting Muscarinic Antagonists for Difficult-to-Treat Asthma: Emerging Evidence and Future Directions.Drugs · 2016Review
- Long-acting muscarinic antagonists: a potential add-on therapy in the treatment of asthma?European respiratory review : an official journal of the European Respiratory Society · 2016Review
- Tiotropium in asthma: what is the evidence and how does it fit in?The World Allergy Organization journal · 2016Review
- Review
- Assessment of second-line treatments for patients with uncontrolled moderate asthma.International journal of clinical and experimental medicine · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomized controlled trials indicate that addition of a long-acting muscarinic antagonist (LAMA) such as tiotropium may improve asthma control and reduce exacerbation risk in patients with poorly controlled asthma, but broader clinical studies are needed to investigate the effectiveness of LAMA in real-life asthma care.
methodsMedical records of adults with asthma (aged ≥18 years) prescribed tiotropium were obtained from the UK Optimum Patient Care Research Database for the period 2001-2013. Patients diagnosed with chronic obstructive pulmonary disease were excluded, but no other clinical exclusions were applied. Two primary outcomes were compared in the year before (baseline) and the year after (outcome) addition of tiotropium: exacerbations (asthma-related hospital emergency department attendance or inpatient admission, or acute oral corticosteroid course) and acute respiratory events (exacerbation or antibiotic prescription with lower respiratory consultation). Secondary outcomes included lung function test results and short-acting β2 agonist usage. The Wilcoxon signed-rank test was used for variables measured on the interval scale, the marginal homogeneity test for categorized variables, and the paired t-test for lung function indices.
resultsOf the 2,042 study patients, 83% were prescribed an inhaled corticosteroid and 68% a long-acting β2 agonist during the baseline year; 67% were prescribed both. Comparing baseline and outcome years, the percentage of patients having at least one exacerbation decreased from 37% to 27% (P<0.001) and the percentage having at least one acute respiratory event decreased from 58% to 47% (P<0.001). There were no significant changes in lung function, and usage of short-acting β2 agonists (in salbutamol/albuterol equivalents) increased from a median (interquartile range) of 274 (110, 548) to 329 (110, 603) μg/day (P=0.01).
conclusionIn this real-life asthma population, addition of LAMA therapy was associated with significant decreases in the incidence of exacerbations and antibiotic prescriptions for lower respiratory tract infections in the following year.
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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.