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Updated: Mar 12, 2026
A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion
Published on: May 12, 2023
Anticholinergic drugs in asthma therapy
Maria D'Amato1, Carolina Vitale, Antonio Molino
1aDepartment of Pneumology, 'Federico II University', AO 'Dei Colli' Monaldi Hospital bRespiratory Department, University of Naples Federico II cDivision of Respiratory Medicine and Allergy, Department of Respiratory Diseases, High Specialty Hospital 'A. Cardarelli' dUniversity of Naples Federico II, School of Specialization in Respiratory Diseases, Naples, Italy.
Long-acting muscarinic antagonists (LAMAs) offer a new treatment option for patients with uncontrolled asthma. These anticholinergic bronchodilators, particularly tiotropium, are safe and effective as add-on therapy when inhaled corticosteroids are insufficient.
Area of Science:
- Pulmonology
- Pharmacology
- Respiratory Medicine
Background:
- Current asthma guidelines recommend stepwise pharmacological therapy.
- However, over 50% of patients remain uncontrolled, risking serious exacerbations and reduced quality of life.
- Anticholinergic bronchodilators, traditionally used for COPD, are gaining interest for uncontrolled asthma.
Purpose of the Study:
- To review the mechanisms supporting the use of anticholinergic bronchodilators as adjunctive therapy in asthma.
- To analyze the role of these agents in specific patient populations.
- To evaluate the safety and efficacy of anticholinergics in asthma management.
Main Methods:
- Review of existing and recent clinical trial data.
- Analysis of real-life evidence on anticholinergic use in asthma.
- Examination of pharmacogenetic and symptom-based profiles.
Main Results:
- Long-acting muscarinic antagonists (LAMAs) are effective as add-on therapy for uncontrolled asthma.
- Anticholinergics may benefit patients intolerant to long-acting β2 agonists, those with specific pharmacogenetic profiles, or nocturnal symptoms.
- Clinical trials and real-world data confirm the safety and efficacy of LAMAs, such as tiotropium, in patients on inhaled corticosteroids.
Conclusions:
- LAMAs represent an important therapeutic option for patients with asthma uncontrolled by standard therapies.
- The safety and efficacy of LAMAs are supported by robust clinical evidence.
- Anticholinergic bronchodilators offer a valuable adjunctive treatment strategy to improve asthma control.
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