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Commentary on: Kerstjens HA, Engel M, Dahl R, et al. Tiotropium in asthma poorly controlled with standard combination therapy. N Engl J Med 2012;367:1198–207.
Three recent well-designed clinical trials demonstrated that tiotropium bromide, when added to an inhaled corticosteroid (ICS), provides asthma control which is non-inferior to adding a long-acting β-agonist (LABA).1–3 The third of these trials also suggested that adding tiotropium to an ICS–LABA combination also provides additional benefit, as measured by an improvement in lung function (FEV1).3 Whether adding tiotropium to patients inadequately controlled on combination ICS–LABA therapy would provide additional benefit by improving long-term asthma control and decreasing severe asthma exacerbations was the subject of the present article.
In two replicate trials of 912 …
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