• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

No significant benefit of long-acting muscarinic antagonists over long-acting beta-agonists in reducing exacerbation risk in uncontrolled, persistent asthma

byQasim HussainiandDaniel Fisher
March 23, 2018
in Chronic Disease, Emergency, Pediatrics, Public Health, Pulmonology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Adjunct long-acting muscarinic antagonist (LAMA) use with corticosteroids was associated with reduced exacerbation risk compared with placebo in patients with uncontrolled, persistent asthma.

2. LAMA, long-acting beta-agonist (LABA), and inhaled corticosteroids (triple therapy) were not associated with lower risk of exacerbations compared to LABA and inhaled corticosteroids alone.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Management of persistent asthma includes the use of daily inhaled corticosteroids (ICS). As disease severity increases, LABAs are added or the dose of ICS increases, but it is unclear what the role for adjunct LAMAs might be. The current study is a systematic review and meta-analysis that analyzed the utility of adding a LAMA as an adjunct therapy to ICS or to ICS and LABA together in patients with uncontrolled, persistent asthma older than 12 years of age. Overall, the addition of a LAMA versus placebo to ICS significantly reduced the risk of exacerbations requiring systemic corticosteroids. However, adding LAMA to ICS did not offer significant improvements in exacerbation risks compared to adding LABA or doubling the dose of ICS. Finally, using LAMA, LABA, and ICS together (triple therapy) was not associated with significant reduction in exacerbation risk.

Overall, the study suggests that while LAMA does significantly reduce the risk of asthma exacerbations compared to placebo, clinical outcomes are similar when compared to adjunct LABA. The study did not consider the harms or costs associated with one treatment over the other, and these may influence clinical practice and treatment decisions. As LAMA (such as tiotropium) is now approved for use in children as young as 6, future studies may evaluate the clinical benefit of treatment with LAMA in this group.

Click to read the study, published in JAMA

Relevant Reading: A phase III randomized controlled trial of tiotropium add-on therapy in children with severe symptomatic asthma.

RELATED REPORTS

Wellness Check: Sleep

Emergency department crowding negative influences outcomes for adults presenting with asthma

The Scan by 2 Minute Medicine®: Overprescribed and Understocked, A Costly Message, A Bad Wrap and Mauna Loa Erupts Again!

In-Depth [systematic review]: The current study is a systematic review and meta-analysis that searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Included studies evaluated patients 12 years and older with uncontrolled, persistent asthma that compared LAMA vs placebo or vs another add-on therapy to ICS or that compared triple therapy (LAMA, LABA and ICS) to ICS and LABA. Progressive increase in asthma symptoms or a decrease in morning peak expiratory flow (PEF) of 30% or more for 2 or more days was defined as an asthma exacerbation. Data synthesis was based on pharmacologic class (LAMA, LABA, or ICS) as opposed to an individual drug. Overall, 15 randomized clinical trials (N = 7122 patients) were identified. Adjunct LAMA, compared to a placebo, demonstrated significant reduction in asthma exacerbation (RR, 0.67 [95% CI, 0.48 to 0.92]. When compared to adjunct LABA, adjunct LAMA did not offer significant benefits in reducing risk of asthma exacerbation (RR, 0.83 [95% CI, 0.53 to 1.42] or other outcomes of interest. Triple therapy was not associated with significant reduction in asthma exacerbation risk (RR, 0.84 [95% CI, 0.57 to 1.22].

Image: CC/Wiki

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: asthmacorticosteroids
Previous Post

Racial/ethnic disparities in cardiovascular health persist in U.S. adults

Next Post

Accountable Care Organizations linked to modest increase in appropriate cancer screening

RelatedReports

Decline in adolescent sleep duration over past 20 years
Wellness

Wellness Check: Sleep

January 19, 2023
Evidence-based interventions for pediatric asthma successfully adapted for community health centers
Emergency

Emergency department crowding negative influences outcomes for adults presenting with asthma

December 27, 2022
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Overprescribed and Understocked, A Costly Message, A Bad Wrap and Mauna Loa Erupts Again!

December 14, 2022
Risk of autism in offspring linked to maternal pregestational diabetes and severe obesity
Chronic Disease

  Vitamin C supplementation in pregnancy improves respiratory function in children of smoking mothers at 5 years of age

December 7, 2022
Next Post
Spiculation of breast masses seen on mammography represents adipose invasion

Accountable Care Organizations linked to modest increase in appropriate cancer screening

Multicomponent nonpharmacological delirium intervention reduced delirium, falls

Medicare's condition-specific readmission measures are poor reflectors of hospital quality

Financial incentive programs significantly improve smoking cessation

E-cigarette use may hamper smoking cessation for smokers planning to quit post-hospitalization

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Bisphosphonates, denosumab, abaloparatide, teriparatide, and romosozumab reduce postmenopausal fracture risk
  • Epstein-Barr viral load monitoring reduces risk of post-liver transplant lymphoproliferative disease
  • Homicide deaths are on the rise for children living in the United States
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options