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Multidisciplinary Respiratory Medicine
Published in: Multidisciplinary Respiratory Medicine 1/2017

Open Access 01-12-2017 | Review

The evidence on tiotropium bromide in asthma: from the rationale to the bedside

Authors: Dejan Radovanovic, Pierachille Santus, Francesco Blasi, Marco Mantero

Published in: Multidisciplinary Respiratory Medicine | Issue 1/2017

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Abstract

Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma. In large randomized clinical trials enrolling patients with moderate to severe asthma, add-on therapy with tiotropium has demonstrated to be efficacious in improving lung function, decreasing risk of exacerbation and slowing the worsening of disease; accordingly, tiotropium demonstrated to be non inferior compared to long acting beta-agonists in the maintenance treatment along with medium to high inhaled corticosteroids. In view of the numerous ancillary effects acting on inflammation, airway remodeling, mucus production and cough reflex, along with the good safety profile and the broad spectrum of efficacy demonstrated in different disease phenotypes, tiotropium can represent a beneficial alternative in the therapeutic management of poorly controlled asthma. The present extensive narrative review presents the pharmacological and pathophysiological basis that guided the rationale for the introduction of tiotropium in asthma treatment algorithm, with a particular focus on its conventional and unconventional effects; finally, data on tiotropium efficacy and safety. from recent randomized clinical trials performed in all age categories will be extensively discussed.
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Metadata
Title
The evidence on tiotropium bromide in asthma: from the rationale to the bedside
Authors
Dejan Radovanovic
Pierachille Santus
Francesco Blasi
Marco Mantero
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Multidisciplinary Respiratory Medicine / Issue 1/2017
Electronic ISSN: 2049-6958
DOI
https://doi.org/10.1186/s40248-017-0094-3

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