Spiriva Respimat reduces risk for asthma worsening, regardless of underlying allergic inflammation

MONTREAL — Spiriva Respimat, as an add-on to inhaled corticosteroids or long-acting beta2 agonists, reduced the risk for severe asthma exacerbation in patients across severities of symptomatic asthma and a broad range of immunoglobulin E and eosinophil values, according to results of four phase 3 trials presented at CHEST Annual Meeting 2015.

Spiriva Respimat is effective regardless of underlying allergic and eosinophilic inflammation, according to the researchers.

"[The data] showed that in patients across different severities of symptomatic asthma and a broad range of immunoglobulin E and eosinophil values, once-daily Spiriva Respimat (tiotropium bromide, Boehringer Ingelheim) added on to at least an inhaled corticosteroid (ICS) with or without [a] long-acting beta2 agonist (LABA), reduced the risk of severe exacerbations and asthma worsening, suggesting efficacy independent of allergic and inflammatory status," Ronald Dahl, MD, a clinical professor in the department of respiratory diseases and allergy at Aarhus University in Denmark, told Healio.com/Pulmonology.

Dahl and colleagues conducted four phase 3, double blind, placebo-controlled trials to evaluate the efficacy of Spiriva Respimat as an add on to ICS in reducing the risk for a severe asthma exacerbation and asthma worsening in adult patients with moderate to severe symptomatic asthma.

The analysis included two 48-week trials (n = 912) of Spiriva Respimat 5 µg or placebo as add-on to high-dose ICS and LABA, as well as two 24-week trials (n = 2,100) of Spiriva Respimat 5 µg, Spiriva Respimat 2.5 µg, or placebo as add-on to medium-dose ICS.

Spiriva Respimat 5 µg demonstrated a reduced risk for severe exacerbation vs. placebo up to an IgE level of 1000 µg/L in the two 48-week trials.

The drug at 5 µg and 2.5 µg also reduced the risk for exacerbation vs. placebo consistently across all IgE and eosinophil levels in the additional two trials.

Spiriva Respimat 5 µg also reduced the risk for asthma worsening vs. placebo, independent of IgE and eosinophils in the 48-week trials.

Dahl told Healio.com/Pulmonology the importance of this finding.

"That means no phenotyping is necessary to specify the subtype of asthma prior to treatment," he said.

The FDA recently approved the use of Spiriva Respimat for asthma in adults and adolescents. – by Ryan McDonald

Reference:

Dahl R, et al. Abstract 202606. Presented at: CHEST Annual Meeting 2015; Oct. 24-28; Montreal.

Disclosure: Please see the abstract for a list of all researchers’ relevant financial disclosures.