Current long-acting muscarinic antagonists for the treatment of asthma

Expert Opin Pharmacother. 2021 Jul 3. doi: 10.1080/14656566.2021.1952182. Online ahead of print.ABSTRACTINTRODUCTION: The role of long-acting muscarinic antagonists (LAMAs) is well established in uncontrolled asthma, but not in milder stages.AREAS COVERED: This review examines the main randomized controlled trials (RCTs) that have investigated LAMAs administered as monotherapy or in combination to asthmatic patients, according to the different phenotypes. It offers an overview of the role of LAMAs or their fixed dose combinations (FDCs) in the treatment across all the different stages of asthma.EXPERT OPINION: Tiotropium is now widely recognized as treatment for moderate to severe uncontrolled asthma (step 4-5) in adults and children. The most recent new evidence is: a) in adults, three different LAMA/long-acting β2-agonist (LABA)/inhaled corticosteroid (ICS) FDCs have been recently approved, extending the treatment options for these patients; b) therapy with LAMAs does not depend on patient's Th2 status and justifies the indication regardless of patient's phenotyping; c) in the milder stages, the high variability of response to LAMAs and the lack of a good phenotyping of patients represents the main obstacle in prescribing LAMAs. A better characterization of parasympathetic tone activity could improve LAMAs prescription.PMID:34219573 | DOI:10.1080/14656566.2021.1952182
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Authors: Source Type: research