![]() British guideline on the management of asthma. Scottish Intercollegiate Guidelines Network (SIGN) and British Thoracic Society. ![]() Cochrane Database of Systematic Reviews 2015, Issue 6. ![]() Long-acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus addition of long-acting beta2-agonists (LABA) for adults with asthma. Kew KM, Evans DJW, Allison DE, Boyter AC. Cochrane Database of Systematic Reviews 2015, Issue 7. Long-acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus higher dose ICS for adults with asthma. DOI: 10.1002/2( )Įvans DJW, Kew KM, Anderson DE, Boyter AC. Cochrane Database of Systematic Reviews 2015, Issue 8. Long-acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus the same dose of ICS alone for adults with asthma. Cochrane Database of Systematic Reviews 2016, Issue 1. Long-acting muscarinic antagonists (LAMA) added to combination long-acting beta2-agonists and inhaled corticosteroids (LABA/ICS) versus LABA/ICS for adults with asthma. The featured image was purchased for Evidently Cochrane from and may not be reproduced. The NICE Evidence Summary New Medicines on tiotropium add-on for asthma is available here Īre long-acting muscarinic antagonists (LAMAs) effective in adults with poorly controlled asthma? by Lynda Ware is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.īased on a work at. Hopefully further high quality evidence will emerge from ongoing and planned trials to determine where LAMAs have their place in asthma management. There would appear to be benefit in adding tiotropium to ICS and salmeterol in patients who remain symptomatic despite these medications.” Longer term studies are required to confirm this evidence. “long-acting muscarinic antagonists appear to be as effective as salmeterol in the short term and may be superior to doubling the dose of ICS in fixed airways obstruction. The current British guideline on the management of asthma states that : Tiotropium appears be beneficial in the treatment of poorly-controlled asthma in adults but it is not clear where it will be assigned a place in the biennial BTS/SIGN asthma guidelines due out in October 2016. It was the case, however, that for many outcomes the evidence was inconclusive or imprecise or the differences were too small to confidently draw any conclusions. ![]() LAMA add-on may reduce the need for rescue oral steroids but the effect was imprecise.(Moderate – high quality of evidence) There were fewer non-serious adverse events. Small benefits were observed in the comparison of LAMA add-on to LABA/ ICS compared to LABA/ICS alone in lung function and asthma control.Asthma-related quality of life measurements were slightly better with LABA add-on. Comparing LAMA to LABA as add-ons to ICS, adding LAMA resulted in small benefits to lung function.LAMA add-on produced a small increase in FEV1 but otherwise the differences between the treatments were too small or imprecise to be sure whether this equated Only one trial was found looking at LAMA add-on to ICS compared to increasing the dose of ICS.In this comparison, LAMA add-on also improved trough FEV1 by around 140ml. The addition of LAMA to ICS resulted in fewer exacerbations requiring oral corticosteroid rescue medication compared to same dose ICS alone. ![]()
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