Tiotropium bromide might provide an alternative to other asthma treatments, expanding options available to patients for controlling their asthma.
Adding Spiriva, known generically as tiotropium bromide, to conventional therapy improves symptoms in patients whose asthma is poorly controlled and gives them more days without breathing problems.
Spiriva is already used for chronic obstructive pulmonary disease and works by blocking the nerves that can tighten the muscles surrounding the airways to the lungs. Some asthma patients need more than the low dose of the corticosteroids they are typically given to inhale, but doctors fear more aggressive treatment can have drawbacks, including making the asthma worse. The goal in managing asthma is to prevent symptoms so patients can pursue activities to the fullest.
Seeking a better treatment, the researchers tested different regimens on 210 patients, all of whom continued inhaling a low dose of corticosteroids. For 14 weeks they received a double dose of the steroid, during another 14-week stretch they added Spiriva, and for a third testing period they inhaled salmeterol, a drug known as a beta agonist that relaxes the muscles lining the breathing passages of the lungs.
Spiriva worked as well as salmeterol and better than doubling the steroid dose. Patients who got Spiriva had improved symptoms and a greater ability to force air from their lungs. The researchers estimated that long-term treatment would give the patients an extra 48 days a year without breathing problems, compared to 19 days if the steroid dose were simply doubled.
Tiotropium relaxes smooth muscle in the airways through a different mechanism than beta agonists, and thus may help people who do not respond well to current recommended treatments. But it did not work for everyone. Nine patients had their asthma get worse while on Spiriva, compared to five while they were receiving salmeterol and 16 when they got a double dose of corticosteroid.
Some doctors are already using Spiriva instead of other secondary drugs when steroids do not provide enough relief, however more research is needed to see whether it can reduce potentially life-threatening episodes of asthma over the long term.
The above results show that tiotropium bromide might provide an alternative to other asthma treatments, expanding options available to patients for controlling their asthma.
Spiriva is already used for chronic obstructive pulmonary disease and works by blocking the nerves that can tighten the muscles surrounding the airways to the lungs. Some asthma patients need more than the low dose of the corticosteroids they are typically given to inhale, but doctors fear more aggressive treatment can have drawbacks, including making the asthma worse. The goal in managing asthma is to prevent symptoms so patients can pursue activities to the fullest.
Seeking a better treatment, the researchers tested different regimens on 210 patients, all of whom continued inhaling a low dose of corticosteroids. For 14 weeks they received a double dose of the steroid, during another 14-week stretch they added Spiriva, and for a third testing period they inhaled salmeterol, a drug known as a beta agonist that relaxes the muscles lining the breathing passages of the lungs.
Spiriva worked as well as salmeterol and better than doubling the steroid dose. Patients who got Spiriva had improved symptoms and a greater ability to force air from their lungs. The researchers estimated that long-term treatment would give the patients an extra 48 days a year without breathing problems, compared to 19 days if the steroid dose were simply doubled.
Tiotropium relaxes smooth muscle in the airways through a different mechanism than beta agonists, and thus may help people who do not respond well to current recommended treatments. But it did not work for everyone. Nine patients had their asthma get worse while on Spiriva, compared to five while they were receiving salmeterol and 16 when they got a double dose of corticosteroid.
Some doctors are already using Spiriva instead of other secondary drugs when steroids do not provide enough relief, however more research is needed to see whether it can reduce potentially life-threatening episodes of asthma over the long term.
The above results show that tiotropium bromide might provide an alternative to other asthma treatments, expanding options available to patients for controlling their asthma.
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