Evidencia de Tiotropio en asma.

Asthma is a chronic disease with a significant disease burden and many patients fail to control the disease despite recommended medical therapy.¹⁹ The long-term goals of asthma management include achieving good control of symptoms, minimizing risk asthma exacerbations, reduce hospitalizations, use of rescue medication, airflow limitation and side effects, as well as allow normal levels of activity.²⁹ According to the Global Initiative for Asthma (GINA) guidelines , asthma management is based on a cornerstone of inhaled corticosteroid therapy (ICS), supplemented with complementary therapies for those with poor or deteriorating disease control.¹ Tiotropium, a long-acting anticholinergic bronchodilator that is administered once a day, it is indicated for the treatment of chronic obstructive pulmonary disease (COPD) for more than a decade and has recently been approved in several countries for the treatment of asthma.¹⁸ In this review, we summarized the significant effect of tiotropium for the treatment of moderate-to-severe asthma, mainly in increasing morning PEF, evening PEF, peak FEV and trough FEV based on high-quality RCTs. Nevertheless, no significant difference in peak FVC, trough FVC, AE and serious AE was found between the 2 groups. A close comparison of the 2 groups revealed that more high-quality larger-sample RCTs are needed to gather more strong evidence on the therapeutic efficacy and safety of tiotropium for clinical practice.