Tiotropium Once-Daily Plus ICS Maintenance May Improve Airflow Obstruction in Adult Asthma

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Demographics and disease characteristics at baseline were similar across all groups.
Demographics and disease characteristics at baseline were similar across all groups.
The following article is part of The Clinical Advisor's coverage from the 2018 American Association of Nurse Practitioners' annual meeting in Denver. Our staff will be reporting live on original research, case studies, and professional outreach and advocacy news from leading NPs in various therapeutic areas. Check back for ongoing updates from AANP 2018. 

DENVER — In adult patients with symptomatic asthma on maintenance inhaled corticosteroid (ICS) therapy, once-daily tiotropium Respimat® (tioR) was found to reduce airflow obstruction, according to research presented at the American Association of Nurse Practitioners (AANP) 2018 National Conference.

Sandhya Khurana, MD, from the University of Rochester in Rochester, NY, and an international team of colleagues sought to assess the impact of treatment with tioR on lung function in patients on maintenance ICS treatment across various body mass index (BMI) subgroups. Patients (n=1351) aged 18 to 75 years were included in 3 phase 3, randomized, double-blind, placebo-controlled, parallel group trials. BMI subgroups were identified as <20 kg/m2, 20-<25 kg/m2, 25-<30 kg/m2, and ≥30kg/m2.

For a duration of 24 weeks, patients with moderate asthma (n=1042) in the Mezzo TinA-asthma® trials (ClinicalTrials.gov Identifiers: NCT01172808 and NCT01172821) received tioR 2.5 µg, tioR 5 µg, salmeterol (50 µg twice daily), or placebo Respimat added to ICS (budesonide 400 to 800 µg or equivalent). In the GraziaTinA-asthma® trial (ClinicalTrials.gov Identifier: NCT01316380), patients with mild persistent asthma (n=309) received tioR 2.5 µg, tioR 5 µg, or placebo added to ICS (budesonide 200 to 400 µg or equivalent) for a duration of 12 weeks.

Peak forced expiratory volume measured for 1 second within 3 hours of dosing (FEV1(0-3h)) and trough FEV1 were analyzed according to each BMI subgroup. Increased peak FEV1(0-3h) and trough FEV1 >100 mL was identified across all BMI groups in patients in MezzoTinA-asthma receiving tioR 2.5 µg vs placebo. In GraziaTinA-asthma, the largest improvements in peak and trough FEV1 with tioR 2.5 µg compared with placebo were observed in the <20 kg/m2 and 25-<30 kg/m2 BMI subgroups.

The authors conclude that “[once-daily] tiotropium Respimat provides benefit to adult patients with persistent symptomatic asthma regardless of BMI.”

For more coverage of AANP 2018, click here.

Disclosure:  This study was sponsored by Boehringer Ingelheim Pharma GmbH & Co.

Reference

Khurana S, AM Kerstjens HAM, Paggiaro P, et al. Once-daily tiotropium Respimat® add-on to inhaled corticosteroid maintenance therapy reduces airflow obstruction in patients with symptomatic asthma, independent of body mass index score. Presented at the American Association of Nurse Practitioners (AANP) 2018 National Conference. June 26-July 1, 2018; Denver, CO. Industry Scientific Poster 18.

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