| AIM To estimate the effectiveness and safety of tiotropium in treating adult patients with asthma.METHODS The randomized controlled trials(RCT) of tiotropium treatment in adult patients with asthma were searched from Medline database, EMbase database,Cochrane Library, Clinical Trials.gov, China Biology Medicine(CBM), China National Knowledge Internet(CNKI), Wanfang database, VIP Chinese database by Computer.Data were collected from inception to September 2014. Keywords: tiotropium、Ba679 BR、Spiriva、Respimat、adult、asthma、bronchial asthma、randomized controlled trial,et al. The relevant references were also retrieved manually. Bias risk of RCTs and quality of documents were evaluated by using modified Jadad rating scale. All data were analyzed and drawed forest polts with Rev Man 5.3. The date were extracted using a pooled weighted mean difference(WMD) or standardized mean difference(SMD) with fixed effects model.RESULTS 434 English, 165 Chinese, 140 repeat literature,178non-RCT and data incomplete documents were founded by initial screening. 72 documents were excluded by the further reading after summary and full text. The finally nine RCTs involving 4 392 patients were included. The results of Meta-analysis revealed that compared with the placebo, tiotropium significantly improved the forced expiratory volume in one second(valley value,WMD=0.11,95%CI:0.09( 0.14,P<0.000 01;peak value, WMD=0.15,95%CI:0.13( 0.18,P<0.000 01), peak expiratory flow rate(morning,WMD=19.97,95%CI:14.26( 25.68,P<0.000 01; evening,WMD=25.02,95%CI:19.23( 30.80,P<0.000 01), and asthma control questionnaire(ACQ) score(WMD=-0.12,95%CI:-0.18(-0.05,P=0.000 6), and significantly decreased the incidence of general adverse reactions(OR=0.72,95%CI:0.61( 0.86,P=0.000 1). However, there were no significant differences in asthma quality of life questionnaire(AQLQ) score and incidence of serious adverse reactions between the two groups(P>0.05).CONCLUSION In the treatment of adult patients with asthma, tiotropium can significantly improve forced expiratory volume in one second, peak expiratory flow,asthma control questionnaire, symptoms and quality of life, and is safety. |
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