Allergy Asthma Immunol Res.  2017 Sep;9(5):386-393. 10.4168/aair.2017.9.5.386.

Positioning of Long-Acting Muscarinic Antagonists in the Management of Asthma

• Aalbers R
• Park HS

• KMID: 2383985
• DOI: http://doi.org/10.4168/aair.2017.9.5.386

Abstract

Despite a range of efficacious therapies for asthma, including inhaled corticosteroids (ICS) and long-acting β₂-agonists (LABA), a significant proportion of patients have poor asthma control and retain a risk of future worsening of their symptoms. Long-acting muscarinic antagonist (LAMA) bronchodilators offer a well-tolerated, efficacious, and cost-effective add-on to a patient's treatment. Of the LAMAs currently under investigation or available for the treatment of asthma, evidence from a comprehensive clinical trial program in adults and children shows that once-daily treatment with tiotropium provides benefits for patients with uncontrolled asthma despite the use of ICS and LABAs. Tiotropium is included in the Global Initiative for Asthma (GINA) strategy document as an add-on therapy option for patients at Step 4 or 5 with a history of asthma exacerbations. Tiotropium Respimat® has demonstrated safety and efficacy in patients with a range of disease severities, ages, and phenotypes. This review describes the evidence for the use of LAMA as add-on therapy for patients with asthma who remain uncontrolled despite the use of ICS and LABA treatments.

Keyword

Asthma; long-acting muscarinic antagonists; tiotropium

MeSH Terms

Adrenal Cortex Hormones
Adult
Asthma*
Bronchodilator Agents
Child
Humans
Muscarinic Antagonists*
Phenotype
Tiotropium Bromide
Adrenal Cortex Hormones
Bronchodilator Agents
Muscarinic Antagonists
Tiotropium Bromide