Summary

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• 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 chronic obstructive pulmonary disease (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 randomized control trials (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, long-acting beta-agonist (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 UMEC/VI demonstrates greater improvements in FEV₁, quality of life, dyspnea, rescue medication use, and exacerbation rates without increased cardiovascular risks.