Intermittent Tiotropium Bromide for Episodic Wheezing: A Randomized Trial
| العنوان: | Intermittent Tiotropium Bromide for Episodic Wheezing: A Randomized Trial |
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| المؤلفون: | Anne Kotaniemi-Syrjänen, Timo Klemola, Petri Koponen, Outi Jauhola, Henrikka Aito, Kristiina Malmström, L. Pekka Malmberg, Eero Rahiala, Seppo Sarna, Anna S. Pelkonen, Mika J. Mäkelä |
| المصدر: | Pediatrics. 150 |
| بيانات النشر: | American Academy of Pediatrics (AAP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Dyspnea, Treatment Outcome, Double-Blind Method, Child, Preschool, Pediatrics, Perinatology and Child Health, Fluticasone, Humans, Albuterol, Tiotropium Bromide, Child, Respiratory Tract Infections, Bronchodilator Agents, Respiratory Sounds |
| الوصف: | BACKGROUND AND OBJECTIVES Options to treat and prevent episodic wheezing in children are scarce. Our objective was to assess the efficacy of intermittent tiotropium bromide treatment in early childhood episodic wheezing. METHODS This 48-week, randomized, open-label, controlled, parallel-group trial was conducted at 4 hospitals in Finland. Children aged 6 to 35 months with 2 to 4 physician-confirmed episodes of wheeze and/or shortness of breath were considered eligible. Study participants were randomly allocated to receive 1 of 3 treatments: once-daily tiotropium bromide 5 µg for 7 to 14 days during respiratory tract infections and as-needed albuterol sulfate 0.2 mg (n = 27), twice-daily fluticasone propionate 125 µg for 7 to 14 days during respiratory tract infections and as-needed albuterol sulfate 0.2 mg (n = 25), or as-needed albuterol sulfate 0.2 mg alone (n = 28). The primary outcome was efficacy, assessed as intention-to-treat by comparing the proportion of episode-free days (the days lacking symptoms or treatments) between the treatment groups. RESULTS The proportion of episode-free days was higher in those receiving intermittent tiotropium bromide (median 97% [interquartile range, 93% to 99%]) than in those receiving intermittent fluticasone propionate (87% [78% to 93%], P = .002), or with as-needed albuterol sulfate alone (88% [79% to 95%], P = .003). Adjustment with allergic sensitization, the baseline number of physician-confirmed episodes of wheeze and/or shortness of breath, or short-course glucocorticoid treatment in the 2 weeks before the enrollment, did not affect the result. Intervention-related adverse events were not seen. CONCLUSIONS Intermittent tiotropium bromide treatment may be an effective alternative to current therapies for episodic wheezing. Before implementation of use, further research on safety and efficacy is indicated. |
| تدمد: | 1098-4275 0031-4005 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b0229344cb0726fa01e26739d6785674Test https://doi.org/10.1542/peds.2021-055860Test |
| رقم الانضمام: | edsair.doi.dedup.....b0229344cb0726fa01e26739d6785674 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10984275 00314005 |
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