2021
DOI: 10.1016/s2213-2600(20)30398-2
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More options for managing severe asthma in adults

Abstract: reduction in exacerbation frequency is not trivial, although it is lower than that anticipated in a population of patients with type 2-high allergic asthma when compared with the effects seen with biologics. In less selected severe asthma populations, such improvements in exacerbation frequency and FEV 1 have formed the basis for the registration of new, long-acting inhaled drugs for asthma. 7,8 Similarly, in chronic obstructive pulmonary disease, such reductions of 15-25% in exacerbation frequency are deemed … Show more

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Cited by 4 publications
(2 citation statements)
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“…Adding tiotropium bromide (TIO) to dual inhaled corticosteroid (ICS)/long-acting β 2 -adrenoceptor agonist (LABA) fixed-dose combination (FDC) is currently recommended to treat asthmatic patients suffering from the most severe forms of disease [1]. Nevertheless, conflicting data are currently available concerning the real efficacy of triple ICS/LABA/long-acting muscarinic receptor antagonist (LAMA) FDCs in asthma, especially with respect to their effect against the risk of exacerbation in symptomatic patients with uncontrolled asthma [2][3][4].…”
Section: Introductionmentioning
confidence: 99%
“…Adding tiotropium bromide (TIO) to dual inhaled corticosteroid (ICS)/long-acting β 2 -adrenoceptor agonist (LABA) fixed-dose combination (FDC) is currently recommended to treat asthmatic patients suffering from the most severe forms of disease [1]. Nevertheless, conflicting data are currently available concerning the real efficacy of triple ICS/LABA/long-acting muscarinic receptor antagonist (LAMA) FDCs in asthma, especially with respect to their effect against the risk of exacerbation in symptomatic patients with uncontrolled asthma [2][3][4].…”
Section: Introductionmentioning
confidence: 99%
“…Even the choice of inhaled therapies has become more and more individualised, given the large spectrum of inhaled corticosteroid molecules, inhaled corticosteroid doses, inhaled corticosteroid fixed combination inhalers, applica tion schemes (maintenance therapy or inhalation on an asneeded basis) and devices. [27][28][29] Thus, today there is an armamentarium of effective, safe, phenotype-specific immunomodulatory drugs aimed at preventing symptoms and exacerbations by targeting the underlying inflammatory cascade, with the advantage of improving control of co-existing co-morbidities (figure). Notably, these drugs do not only successfully modulate inflammation, 19 but can improve the function of structural cells, such as epithelial cells, smooth muscle cells, fibroblasts, and nerves, and consequently reduce airway remodelling.…”
mentioning
confidence: 99%