The use of anticholinergic medications is well established as maintenance therapy for chronic obstructive pulmonary disease (COPD) and there is a growing interest in the use of anticholinergic medications in the treatment of moderate to severe asthma. Several recent clinical trials have provided evidence for the use of tiotropium as add-on therapy for asthma. Tiotropium was superior to doubling the dose of an inhaled corticosteroid (ICS) based on change in morning peak expiratory flow (PEF). Two large multinational trials provide evidence for the use of tiotropium in a subset of asthmatic patients who have not achieved control using combination therapy with an ICS and a long-acting β2 agonist (LABA).
Further studies are needed to better define which phenotypic subset of patients would benefit most from the use of tiotropium.
References:
Long-acting anticholinergics in the treatment of asthma. Guyer, Autumn Chandler; Long, Aidan Angelo. Current Opinion in Allergy & Clinical Immunology, August 2013 - Volume 13 - Issue 4 - p 392-398.
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