ArticleNPJ primary care respiratory medicine2014
Is there a rationale and role for long-acting anticholinergic bronchodilators in asthma?
Article in NPJ primary care respiratory medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 44 citations in OpenAlex.
- Triple Therapy with Budesonide/Glycopyrrolate/Formoterol Fumarate Improves Inspiratory Capacity in Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap.International journal of chronic obstructive pulmonary disease · 2020Trial
- Efficacy and safety of ipratropium bromide/albuterol compared with albuterol in patients with moderate-to-severe asthma: a randomized controlled trial.BMC pulmonary medicine · 2016Trial
- The new era of add-on asthma treatments: where do we stand?Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2022Review
- The novel TRPA1 antagonist BI01305834 inhibits ovalbumin-induced bronchoconstriction in guinea pigs.Respiratory research · 2021Article
- Inhaled Formoterol-Fluticasone Single Inhaler Therapy in Asthma: Real-World Efficacy, Budget Impact, and Potential to Improve Adherence.Canadian respiratory journal · 2020Review
- Clinical efficacy and safety of anticholinergic therapies in pediatric patients.Therapeutics and clinical risk management · 2019Review
- Effect of Tiotropium Bromide on Airway Inflammation and Programmed Cell Death 5 in a Mouse Model of Ovalbumin-Induced Allergic Asthma.Canadian respiratory journal · 2019Article
- The mode of action of anticholinergics in asthma.The European respiratory journal · 2018Review
- Structure-based discovery of selective positive allosteric modulators of antagonists for the MProceedings of the National Academy of Sciences of the United States of America · 2018Article
- An algorithmic approach for the treatment of severe uncontrolled asthma.ERJ open research · 2018Review
- Positioning of Long-Acting Muscarinic Antagonists in the Management of Asthma.Allergy, asthma & immunology research · 2017Review
- The evidence on tiotropium bromide in asthma: from the rationale to the bedside.Multidisciplinary respiratory medicine · 2017Review
- Genetics and Genomics of Longitudinal Lung Function Patterns in Individuals with Asthma.American journal of respiratory and critical care medicine · 2016Observational
- Long-Acting Muscarinic Antagonists for Difficult-to-Treat Asthma: Emerging Evidence and Future Directions.Drugs · 2016Review
- Long-acting muscarinic antagonists: a potential add-on therapy in the treatment of asthma?European respiratory review : an official journal of the European Respiratory Society · 2016Review
- Pharmacotherapy in the management of asthma in the elderly: a review of clinical studies.Asia Pacific allergy · 2016Review
- Working in harmony with Nature: highlights from 2014, and a look to the future.NPJ primary care respiratory medicine · 2015Article
- Long-acting muscarinic antagonist use in adults with asthma: real-life prescribing and outcomes of add-on therapy with tiotropium bromide.Journal of asthma and allergy · 2015Article
- Assessment of second-line treatments for patients with uncontrolled moderate asthma.International journal of clinical and experimental medicine · 2015Article
- Anticholinergics/antimuscarinic drugs in asthma.Current allergy and asthma reports · 2014Review
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite current guidelines and the range of available treatments, over a half of patients with asthma continue to suffer from poor symptomatic control and remain at risk of future worsening. Although a number of non-pharmacological measures are crucial for good clinical management of asthma, new therapeutic controller medications will have a role in the future management of the disease. Several long-acting anticholinergic bronchodilators are under investigation or are available for the treatment of respiratory diseases, including tiotropium bromide, aclidinium bromide, glycopyrronium bromide, glycopyrrolate and umeclidinium bromide, although none is yet licensed for the treatment of asthma. A recent Phase III investigation demonstrated that the once-daily long-acting anticholinergic bronchodilator tiotropium bromide improves lung function and reduces the risk of exacerbation in patients with symptomatic asthma, despite the use of inhaled corticosteroids (ICS) and long-acting β2-agonists (LABAs). This has prompted the question of what the rationale is for long-acting anticholinergic bronchodilators in asthma. Bronchial smooth muscle contraction is the primary cause of reversible airway narrowing in asthma, and the baseline level of contraction is predominantly set by the level of 'cholinergic tone'. Patients with asthma have increased bronchial smooth muscle tone and mucus hypersecretion, possibly as a result of elevated cholinergic activity, which anticholinergic compounds are known to reduce. Further, anticholinergic compounds may also have anti-inflammatory properties. Thus, evidence suggests that long-acting anticholinergic bronchodilators might offer benefits for the maintenance of asthma control, such as in patients failing to gain control on ICS and a LABA, or those with frequent exacerbations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.