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  • P229 Once-daily Tiotropium Respimat® As Add-on To At Least Medium- To High-dose Ics, With Or Without Laba, Improves Lung Function In Patients With Symptomatic Asthma, Independent Of Allergic Status

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Asthma treatments
P229 Once-daily Tiotropium Respimat® As Add-on To At Least Medium- To High-dose Ics, With Or Without Laba, Improves Lung Function In Patients With Symptomatic Asthma, Independent Of Allergic Status
  1. R Dahl1,
  2. T Casale2,
  3. E Pizzichini3,
  4. M Vandewalker4,
  5. JC Virchow5,
  6. M Engel6,
  7. R Sigmund6,
  8. P Moroni-Zentgraf6,
  9. HAM Kerstjens7
  1. 1Odense University Hospital, Allergy Centre, Odense, Denmark
  2. 2University of South Florida, Morsani College of Medicine, Tampa, USA
  3. 3NUPAIVA (Asthma Research Centre), Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
  4. 4Clinical Research of the Ozarks, Colombia, USA
  5. 5Intensive Care Medicine, Zentrum Für Innere Medizin, Klinik I, University Clinic Rostock, Rostock, Germany
  6. 6Boehringer Ingelheim Pharma GmbH and Co. KG, Ingelheim Am Rhein, Germany
  7. 7University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands

Abstract

Background A substantial number of patients have symptomatic asthma despite treatment according to guidelines. Several studies have confirmed that tiotropium Respimat®, a once-daily long-acting anticholinergic bronchodilator, improves lung function in symptomatic patients receiving at least medium-dose inhaled corticosteroids (ICS) + long-acting β2-agonist (LABA) (Kerstjens et al. NEJM 2012;367:1198–207; Bateman et al. JACI 2011;128:315–22). Here we examine whether the atopic and/or allergic status of patients in these trials influenced their response to tiotropium Respimat®.

Method Two 48-week trials of tiotropium Respimat® 5 µg (PrimoTinA-asthma®: NCT00776984, NCT00772538) in patients (n = 912) on high-dose ICS + LABA; two 24-week trials of tiotropium Respimat® 5 µg and 2.5 µg (MezzoTinA-asthma®: NCT01172808, NCT01172821) in patients (n = 2100) on moderate-dose ICS. Pre-planned analyses (pooled populations) were performed in two subgroups defined at baseline as total serum immunoglobulin E (IgE) ≤ or >430 μg/L or blood eosinophils ≤ or >0.6×109/L or clinical judgement of allergic status (‘No’ or ‘Yes’). All tiotropium doses were delivered via the Respimat® SoftMist™ inhaler.

Results Tiotropium Respimat® 5 µg or 2.5 µg improved peak and trough forced expiratory volume in 1 second versus placebo (Table) independent of IgE, eosinophil count and clinical judgement.

Conclusion Once-daily tiotropium Respimat® as add-on to ICS or ICS + LABA in patients with moderate to severe symptomatic asthma reduces airflow obstruction, apparently independent of their atopic and/or allergic status.

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Abstract P229 Table 1

https://doi.org/10.1136/thoraxjnl-2014-206260.357

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