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Tiotropium Bromide in Children and Adolescents with Asthma

Abstract

Evidence is emerging on the use of long-acting muscarinic antagonists (LAMAs) in the management of asthma. Tiotropium bromide (Spiriva® Respimat®) is the only LAMA approved in children and adolescents. As the use of tiotropium becomes more common in clinical practice, it is necessary to review the existing data to identify patients who may benefit from the addition of this medication to their daily asthma regimen. This review discusses recent evidence on the safety and efficacy of tiotropium bromide in the management of asthma in children and adolescents. Current data support that tiotropium bromide has a bronchodilator effect, as evident by improvements in acute lung function compared with placebo; however, data are not yet available to present a stepwise approach or identify phenotypes that would benefit from the addition of tiotropium bromide. Well-designed studies are needed to compare the different step-up options to tiotropium bromide and provide an evidence-based stepwise approach for the management of asthma in children. Furthermore, study design should include identification of phenotypes that might experience a better clinical response to tiotropium bromide compared with other adjunct medications.

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Correspondence to Hengameh H. Raissy.

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H. H. Raissy and H. W. Kelly have received no financial assistance for the preparation of this manuscript.

Conflicts of interest

H. H. Raissy is the principal investigator of AsthmaNet at the University of New Mexico, which has received drugs from GlaxoSmithKline and Merck for use in clinical trials. H. W. Kelly has received remuneration for work on the steering committees for the FDA-mandated safety trials of ICS/LABA combinations for GlaxoSmithKline, AstraZeneca, Merck, and Novartis and for acting in an advisory capacity for GlaxoSmithKline for their FDA submission of a new ICS/LABA combination. He is a member of AsthmaNet, which has received drugs from GlaxoSmithKline, Merck, Sunovion, Teva, and Boehringer Ingelheim for use in clinical trials.

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Raissy, H.H., Kelly, H.W. Tiotropium Bromide in Children and Adolescents with Asthma. Pediatr Drugs 19, 533–538 (2017). https://doi.org/10.1007/s40272-017-0258-9

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  • DOI: https://doi.org/10.1007/s40272-017-0258-9