The quality of evidence is downgraded by imprecise results (wide confidence intervals and few outcome events).
A Cochrane review [Abstract] 1 included 3 studies with a total of 1 197 subjects with asthma taking combination long-acting beta-agonist and inhaled corticosteroid (LABA+ICS). People in the studies had a mean forced expiratory volume in one second (FEV1) of 55% of their predicted value, indicating severe asthma.People randomised to take tiotropium add-on seemed to have fewer exacerbations requiring oral corticosteroids and fewer exacerbations requiring hospital admission than those continuing to take LABA+ICS alone, but the confidence intervals did not rule out no difference over 48 weeks (table T1). Lung function tests (FEV1 and FVC) were slightly better with tiotropium. There was no difference in quality of life. People taking tiotropium add-on were less likely to experience non-serious or serious adverse events.
| Outcome | Relative effect(95% CI) | Risk with placebo | Risk with tiotropium (95% CI) | Participants (studies) |
|---|---|---|---|---|
| Exacerbations requiring oral corticosteroids | OR 0.76(0.57 to 1.02) | 328 per 1000 | 271 per 1000(218 to 333) | 907(2) |
| Exacerbations requiring hospital admission | OR 0.68(0.34 to 1.38) | 43 per 1000 | 30 per 1000 (15 to 59) | 1 191 (3) |
| Any adverse events | OR 0.70(0.52 to 0.94) | 813 per 1000 | 753 per 1000 (693 to 803) | 1 197 (3) |
| Serious adverse events | OR 0.60(0.24 to 1.47) | 96 per 1000 | 60 per 1000 (25 to 134) | 1 197 (3) |
Date of latest search: 8 January 2016
Primary/Secondary Keywords