Drug updated on 4/16/2024
| Dosage Form | Inhalation spray (oral; 1.25 mcg or 2.5 mcg (2.5 mcg or 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.
Summary
- Tiotropium bromide (Spiriva Respimat) is approved for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), and for reducing COPD exacerbations; it's also used in the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older.
- Two systematic reviews/meta-analyses were reviewed which evaluated the efficacy and safety profile of tiotropium bromide as an add-on therapy to inhaled corticosteroid (ICS) regimen for adults with mild to moderate uncontrolled persistent asthma.
- The first review found that 2.5 µg tiotropium Respimat improved lung function parameters including peak and trough forced expiratory volume in one second and peak and trough forced vital capacity compared to placebo across different age groups suffering from varying severities of asthma.
- In terms of safety profile, this study reported that overall adverse events were comparable between those receiving 2.5 µg tiotropium Respimat or a placebo; common side effects included worsening asthma symptoms, reduction in peak expiratory rate, nasopharyngitis,and respiratory tract infections.
- The second review concluded that adding tiotropium to low- or medium-dose ICS significantly improved lung function among adult patients with moderate uncontrolled asthma without increasing serious adverse events incidence compared to using only ICS alone.
- However both studies highlighted need for more well-designed trials over longer durations due their limitations such as high risk bias due lack washout periods between interventions noted by one study while other was limited by small number identified studies available at time research conducted.
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
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Asthma guideline updates. | 2022 | ACSAP: Pulmonary Care |