Drug updated on 11/4/2024
| Dosage Form | Inhalation spray (oral; 1.25 mcg, 2.5 mcg) |
| Drug Class | Anticholinergics |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), and for reducing COPD exacerbations
- Indicated for the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older.
Latest News
Summary
- This summary is based on the review of three systematic review(s)/meta-analysis(es). [1-3]
- Tiotropium bromide (Spiriva Respimat) was effective as an add-on maintenance treatment for children and adolescents aged 6-17 years with symptomatic moderate and severe asthma who were already on inhaled corticosteroids, with or without additional controllers.
- Umeclidinium/vilanterol (UMEC/VI) showed statistically significant improvements over tiotropium in forced expiratory volume in 1 second (FEV1), St George's Respiratory Questionnaire (SGRQ) total score, Transitional Dyspnoea Index (TDI) focal score, reduced rescue medication use, and lower moderate/severe exacerbation rate among COPD patients.
- Tiotropium bromide was reported as safe for children and adolescents aged 6-17 years with symptomatic asthma, with no specific adverse events noted.
- A meta-analysis including 20 RCTs with over 27,699 subjects found no increased risk of cardiovascular events, overall mortality, or cardiovascular mortality associated with tiotropium use in COPD patients compared to non-anticholinergic treatments, LABA, and placebo, with consistent results across subgroup analyses.
- Tiotropium bromide (Spiriva Respimat) is effective and safe as an add-on maintenance treatment for children and adolescents aged 6-17 years with symptomatic moderate and severe asthma. In adults with COPD, tiotropium is effective, but umeclidinium/vilanterol (UMEC/VI) demonstrates greater improvements in FEV1, quality of life, dyspnea, rescue medication use, and exacerbation rates without increased cardiovascular risks.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Spiriva Respimat (tiotropium bromide) Prescribing Information. | 2021 | Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Comparative efficacy of umeclidinium/vilanterol versus other bronchodilators for the treatment of chronic obstructive pulmonary disease: a network meta-analysis. | 2022 | Advances in Therapy |
| Tiotropium in the management of paediatric and adolescent asthma: Systematic review | 2021 | Paediatric Respiratory Reviews |
| Association of tiotropium use and the risk of adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials. | 2020 | European Journal of Clinical Pharmacology |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Asthma guideline updates. | 2022 | ACSAP: Pulmonary Care |
| Management of Severe Asthma: a European Respiratory Society/American Thoracic Society Guideline | 2020 | The European Respiratory Journal |