Commonly Used COPD Drug Benefits People with Asthma Not Controlled with Corticosteroids

A recent study finds commonly used chronic obstructive pulmonary disease (COPD) drug, tiotropium bromide, helps adult patients whose asthma is poorly controlled with the current standard low-dosed inhaled corticosteroids. Tiotropium bromide is an anticholinergic drug that helps relax or open up airway passages. The new finding may lead to the development of a new alternative therapy for controlling asthma.

Current recommended treatments for not well-controlled asthma by low doses of inhaled corticosteroids are either increasing the dosage or adding long-acting beta agonists such as salmeterol. However, these treatment options may not be ideal solutions. According to the National Institutes of Health (NIH), increasing the dosage of inhaled corticosteroids does not effectively improve symptoms of all patients. In addition, it can also have significant side effects. Long-acting beta agonists have recently come under serious scrutiny because of the possibility of making asthma symptoms worse, resulting in hospitalization.

Researchers, lead by Dr. Stephen Peters of the Wake Forest University Baptist Medical Center, compared three treatment options for asthma: 'doubling the dose of inhaled corticosteroids alone, supplementing a low dose of inhaled corticosteroids with a long-acting beta agonist (salmeterol), and supplementing a low dose of inhaled corticosteroids with a long-acting anticholinergic drug (tiotropium bromide).'

The study was comprised of 210 adults whose asthma symptoms were poorly controlled with low doses of inhaled corticosteroids alone. The participants were given each treatment for 14 weeks, followed by a two-week break before starting with the other treatment option.

The researchers found that supplementing low doses of inhaled corticosteroids with tiotropium bromide is more effective in managing asthma than increasing inhaled corticosteroids alone. They also found that it is as effective as low-dosed inhaled corticosteroids added with long-acting beta agonist salmeterol. The results of the study were published online in the September 29 issue of the New England Journal of Medicine and presented at the Annual Congress of the European Respiratory Society in Barcelona, Spain.

Asthma is a chronic lung disease affecting more than 22 million people in the United States and more than 6 million of them are children, according to the Centers for Disease Control and Prevention (CDC). It can cause inflammation and narrowing of airway passages making breathing difficult. The condition can occur in people at any age. However, asthma commonly starts in childhood.

"This study's results show that tiotropium bromide might provide an alternative to other asthma treatments, expanding options available to patients for controlling their asthma," said National Heart, Lung, and Blood Institute (NHLBI) Acting Director Susan B. Shurin, M.D. She added, "The goal in managing asthma is to prevent symptoms so patients can pursue activities to the fullest."

Sources:

National Heart, Lung, and Blood Institute. Possible Alternate Therapy for Adults with Poorly Controlled Asthma. Accessed on September 27, 2010.

National Institutes of Health: NIH Research Matters. Alternate Therapy for Poorly Controlled Asthma. Accessed on September 27, 2010.

Centers for Disease Control and Prevention. Asthma Prevalence, Health Care Use and Mortality: United States, 2003-05. Accessed on September 27, 2010.