Evaluation of inhaled tiotropium in asthma, uncontrolled with standard combination therapy.

Introduction: In uncontrolled asthma, the suboptimally inhibited airways inflammation is the main pathogenic event. Addition of other medications to the regular regimen might be able to improve disease control by enhancing bronchodilation and/or by reducing the bronchial inflammation. Tiotropium is currently under evaluation as a potential such therapy.

Areas Covered: The long-term efficacy and safety of tiotropium was recently evaluated in two studies in patients with poorly controlled asthma under inhaled corticosteroids + long-acting β2 agonists. Tiotropium was able to improve lung function and the effect was sustained, reduced the exacerbations risk (and in particular severe exacerbations risk), but had a marginal effect on symptoms and on quality of life.

Expert Opinion: In asthma, inhaled tiotropium is able to increase the bronchodilation, and might also be able to exert an anti-inflammatory effect.