Introduction

The increased acetylcholine signaling in asthma pathophysiology offers the rationale for the use of LAMAs in the treatment of asthmatic patients. Tiotropium is still the only LAMA approved for use in asthma but there is a real interest in developing novel LAMAs for the treatment of asthma, or at least to extend this indication to other LAMAs already on the market.

Areas covered

We examined and discussed trials and research that have studied or are evaluating the role of LAMAs already on the market in asthma and possible novel muscarinic acetylcholine receptor antagonists.

Expert opinion

Glycopyrronium and umeclidinium will soon be included in the GINA strategy with the same current indications of tiotropium. It is likely that the choice of the LAMA will be influenced not so much by its pharmacological profile as by the type of triple therapy chosen. It is extremely difficult to identify a new LAMA that is more effective than tiotropium, but is it plausible that new technologies that will allow delivering the drug in a more targeted way and with a lower risk of adverse effects may represent the real progress in the use of LAMAs in asthma in the coming years.

中文翻译：

---

新兴的毒蕈碱受体拮抗剂可治疗哮喘。

介绍

哮喘病理生理中乙酰胆碱信号转导的增加为使用LAMA治疗哮喘患者提供了理论依据。噻托溴铵仍然是唯一获准用于哮喘的LAMA，但对开发用于治疗哮喘的新型LAMA或至少将其适应症扩展到已经在市场上出售的其他LAMA的兴趣浓厚。

覆盖区域

我们检查和讨论了已经研究或正在评估的LAMAs在哮喘中的作用和可能的新型毒蕈碱乙酰胆碱受体拮抗剂的试验和研究。

专家意见

Glycopyrronium和umeclidinium很快将被纳入GINA策略中，目前与噻托溴铵的适应症相同。LAMA的选择可能受其药理学特征的影响不大，受所选三联疗法类型的影响不大。确定比噻托溴铵更有效的新LAMA极为困难，但是，可以使药物靶向性更强，不良反应风险更低的新技术可能代表了使用的真正进展，这似乎是合理的。未来几年中LAMA在哮喘中的应用。