New perspectives on the role of muscarinic antagonists in asthma therapy.

New perspectives on the role of muscarinic antagonists in asthma therapy. Expert Rev Respir Med. 2020 Apr 22;: Authors: Matera MG, Belardo C, Rinaldi M, Rinaldi B, Cazzola M Abstract Introduction: Tiotropium is useful in the presence of severe uncontrolled asthma despite the optimization of therapy with inhaled corticosteroids (ICSs) and long-acting β2 agonists (LABAs) as recommended by the current guidelines. However, in recent years there has been some further preclinical and clinical evidence on the pharmacological and therapeutic impact of these agents.Areas covered: We have conducted an extensive search on muscarinic antagonists in asthma therapy throughout several sources and discuss what has emerged in the last three years (January 2017-March 2020).Expert opinion: New evidence indicates that the effectiveness of adding a long-acting muscarinic antagonist (LAMA), at least tiotropium, is independent of the degree of the type 2 inflammation and age of patient. Therefore, tiotropium can be administered without the need for patient phenotyping. Umeclidinium and glycopyrronium also appear effective in asthma. Initial treatment with LAMA+ICS for those with mild asthma may be an equally effective therapeutic option as LABA+ICS but this hypothesis should be confirmed by statistically powered trials. PMID: 32316778 [PubMed - as supplied by publisher]
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research