PMID- 35933228
OWN - NLM
STAT- MEDLINE
DCOM- 20220913
LR  - 20221006
IS  - 1097-6825 (Electronic)
IS  - 0091-6749 (Linking)
VI  - 150
IP  - 3
DP  - 2022 Sep
TI  - Optimizing asthma management: Role of long-acting muscarinic antagonists.
PG  - 557-568
LID - S0091-6749(22)00883-1 [pii]
LID - 10.1016/j.jaci.2022.06.015 [doi]
AB  - Patients with asthma who are suboptimally responsive to inhaled corticosteroids 
      (ICS) and long-acting beta(2)-agonists (LABAs) are frequently exposed to oral 
      corticosteroids and high-dose ICS, which can lead to significant side effects. 
      Long-acting muscarinic antagonists (LAMAs) have demonstrated efficacy and safety 
      in a subset of these patients. This review summarizes the results of key studies 
      using LAMAs in patients with asthma aged 12 years or older. LAMA as an add-on 
      treatment improved lung function and asthma control in patients with uncontrolled 
      asthma across studies. The efficacy of LAMAs as an add-on to ICS was superior to 
      that of placebo and ICS dose escalation and comparable with that of LABAs. LAMA 
      plus ICS plus LABA provided modest improvements in bronchodilation and increased 
      the time to first severe exacerbation versus ICS plus LABA. Single-inhaler triple 
      therapy was associated with decreased health care resource utilization and 
      improved cost-effectiveness versus multiple inhalers. LAMAs were generally well 
      tolerated; asthma exacerbations, bronchitis, and nasopharyngitis were common 
      adverse events with LAMA in combination with ICS alone or ICS plus LABA. Thus, 
      the overall evidence presented in this review supports the use of add-on LAMA 
      treatment as a reasonable option in patients with asthma uncontrolled with ICS 
      plus LABA or ICS alone.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Casale, Thomas B
AU  - Casale TB
AD  - Division of Allergy and Immunology, University of South Florida, Tampa, Fla. 
      Electronic address: tbcasale@usf.edu.
FAU - Foggs, Michael B
AU  - Foggs MB
AD  - Advocate Health Care, Chicago, Ill.
FAU - Balkissoon, Ronald C
AU  - Balkissoon RC
AD  - Division of Pulmonary, Critical Care & Sleep Medicine, National Jewish Health, 
      Denver, Colo.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20220803
PL  - United States
TA  - J Allergy Clin Immunol
JT  - The Journal of allergy and clinical immunology
JID - 1275002
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Muscarinic Antagonists)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenal Cortex Hormones
MH  - Adrenergic beta-2 Receptor Agonists/therapeutic use
MH  - *Asthma/chemically induced/drug therapy
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Muscarinic Antagonists/therapeutic use
MH  - *Pulmonary Disease, Chronic Obstructive/drug therapy
OTO - NOTNLM
OT  - Asthma
OT  - long-acting muscarinic antagonists
OT  - management
EDAT- 2022/08/07 06:00
MHDA- 2022/09/14 06:00
CRDT- 2022/08/06 22:04
PHST- 2021/10/27 00:00 [received]
PHST- 2022/06/17 00:00 [revised]
PHST- 2022/06/21 00:00 [accepted]
PHST- 2022/08/07 06:00 [pubmed]
PHST- 2022/09/14 06:00 [medline]
PHST- 2022/08/06 22:04 [entrez]
AID - S0091-6749(22)00883-1 [pii]
AID - 10.1016/j.jaci.2022.06.015 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol. 2022 Sep;150(3):557-568. doi: 10.1016/j.jaci.2022.06.015. 
      Epub 2022 Aug 3.