Tiotropium for Asthma — Promise and Caution
Anticholinergic agents have been available for the treatment of airways obstruction for many decades. For patients with chronic obstructive pulmonary disease (COPD), many practitioners believe that these drugs have become the bronchodilator of choice. For patients with asthma, anticholinergic agents are less popular, probably because of their slower onset of action as a reliever medication and their generally inferior effect on lung function and symptoms, as compared with inhaled beta-agonists.
Not surprisingly, long-acting beta-agonists (LABAs) in combination with inhaled glucocorticoids have become standard treatment for patients with asthma that is poorly controlled while receiving inhaled glucocorticoids alone.