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New perspectives on the role of muscarinic antagonists in asthma therapy.
Matera, Maria Gabriella; Belardo, Carmela; Rinaldi, Michele; Rinaldi, Barbara; Cazzola, Mario.
Affiliation
  • Matera MG; Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy.
  • Belardo C; Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy.
  • Rinaldi M; Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "Luigi Vanvitelli" , Naples, Italy.
  • Rinaldi B; Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy.
  • Cazzola M; Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata" , Rome, Italy.
Expert Rev Respir Med ; 14(8): 817-824, 2020 08.
Article in En | MEDLINE | ID: mdl-32316778
INTRODUCTION: There is increasing evidence that tiotropium, a long-acting muscarinic agent (LAMA), is useful in the presence of severe-uncontrolled asthma despite the optimization of therapy with inhaled corticosteroids (ICSs) and long-acting ß2 agonists (LABAs) as recommended by the current guidelines. Furthermore, in recent years there have been several  preclinical and clinical studies on the pharmacological and therapeutic impact of other LAMAs in asthma. AREAS COVERED: We have conducted an extensive search on muscarinic antagonists in asthma therapy throughout several sources and discuss what has emerged in the last 3 years (January 2017-March 2020). EXPERT OPINION: New evidence indicates that the effectiveness of adding a LAMA, at least tiotropium, is independent of the degree of the type 2 inflammation and age of patient. Therefore, tiotropium can be administered without the need for patient phenotyping. Umeclidinium and glycopyrronium also appear effective in asthma. Initial treatment with LAMA+ICS for those with mild asthma may be an equally effective therapeutic option as LABA+ICS but this hypothesis should be confirmed by statistically powered trials.
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Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_biologicas / Peloideterapia Main subject: Asthma / Muscarinic Antagonists Type of study: Guideline Language: En Journal: Expert Rev Respir Med Year: 2020 Type: Article Affiliation country: Italy

Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_biologicas / Peloideterapia Main subject: Asthma / Muscarinic Antagonists Type of study: Guideline Language: En Journal: Expert Rev Respir Med Year: 2020 Type: Article Affiliation country: Italy