Does Adding Tiotropium to ICS Treatment Improve Asthma Symptoms?
Adding tiotropium to inhaled corticosteroid (ICS) treatment improves lung function and reduces symptoms in children with severe asthma, according to the findings of a recent study.
The researchers conducted 2 randomized, double-blind, placebo-controlled, parallel group trials that included a total of 792 children aged 6 to 17 years. Patients either took 2 puffs of tiotropium administered via Respimat at either a dose of 2.5 μg or 5 μg, or placebo once a day for 12 weeks as add-on to ICS and other controller medications. Changes from baseline to week 12 in peak forced expiratory volume in 1 second (FEV1) within 3 hours post-dose was assessed as the primary endpoint, and pre-dose FEV1 response and time to first asthma exacerbation were assessed as the secondary endpoints.
Both doses of tiotropium showed improvements in pre- and peak FEV1 measurements across a range of baseline immunoglobulin E (IgE) and blood eosinophil counts compared with placebo. The hazard ratios for time to first asthma exacerbation was less than 1 for patients taking both doses of tiotropium compared with placebo, regardless of baseline IgE and blood eosinophil counts.
“Once-daily tiotropium Respimat add-on to ICS maintenance therapy with or without additional controls provides benefits in lung function and asthma exacerbation risk in children and adolescents with severe symptomatic asthma, irrespective of IgE levels and blood eosinophil counts,” the researchers concluded. “This indicates that tiotropium is effective without requirement for these phenotyping parameters.”
—Melissa Weiss
Reference:
Goldstein S, Vogelberg C, Hamelmann E, et al. Tiotropium Respimat add-on is effective in children and adolescents with severe symptomatic asthma, irrespective of immunoglobulin E levels and eosinophil count. Presented at: American Thoracic Society 2017 International Conference; May 19-24, 2017; Washington DC. http://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A5101