title: Tiotropium may improve asthma symptoms and lung function in asthmatic patients with irreversible airway obstruction: the real-life data.
abstract: OBJECTIVE
  Some patients with asthma have poorly controlled disease despite the use of high-dose inhaled corticosteroids (ICS), long-acting β2 agonists (LABAs) and antileukotrienes. The aim of the study was to assess the effectiveness of tiotropium as an add-on therapy to the standard treatment with high-dose ICS/LABA on asthma control and lung function in patients with severe asthma.
  
  
  METHODS
  Of the 633 asthmatic patients, 64 (10.1%) patients with severe asthma who were add-on treated at least for 3 months were evaluated. Number of exacerbations, emergency department visits, hospitalizations and lung functions of patients belonging to 12 months before starting add-on treatment were compared with those of 12 months after starting add-on treatment.
  
  
  RESULTS
  The mean duration of add-on tiotropium treatment was 8.3 ± 0.5 months. For patients with severe asthma that was poorly controlled with standard combination therapy, tiotropium improved asthma control in 42.2%, decreased the number of emergency department visits in 46.9% and decreased the number of hospitalizations in 50.0% of them. The mean baseline forced expiratory volume in 1 s before add-on tiotropium was 57.5 ± 1.9% and forced vital capacity was 74.3 ± 15.6%. However, after 12 months of add-on tiotropium treatment, these rates became 65.5 ± 1.9% and 82.5 ± 15.1%, respectively. The addition of tiotropium significantly improved the percentages of the number of emergency department visits, the number of hospitalizations (P < 0.05).
  
  
  CONCLUSIONS
  Our study has suggested that, for patients with poorly controlled asthma despite of the use of ICS/LABA, the addition of tiotropium to standard care may be beneficial.
authors.affiliation: Department of Chest Diseases, Subdepartment of Immunology and Allergy Diseases, Faculty of Medicine, Cumhuriyet Üniversity, Sivas, Turkey.
authors.forename: Oznur
authors.initials: O
authors.lastname: Abadoglu
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Cumhuriyet Üniversity, Sivas, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Berk
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000188:drug therapy* / Q000503:physiopathology; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D013806:Theophylline / Q000008:administration & dosage; D000069447:Tiotropium Bromide / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D020024:Leukotriene Antagonists; D013806:Theophylline; D011241:Prednisone; D000069447:Tiotropium Bromide
keywords: airway obstruction; asthma; high-dose inhaled steroid; tiotropium