Stephen P Peters, Susan J Kunselman, Nikolina Icitovic, Wendy C Moore, Rodolfo Pascual, Bill T Ameredes, Homer A Boushey, William J Calhoun, Mario Castro, Reuben M Cherniack, Timothy Craig, Loren Denlinger, Linda L Engle, Emily A DiMango, John V Fahy, Elliot Israel, Nizar Jarjour, Shamsah D Kazani, Monica Kraft, Stephen C Lazarus, Robert F Lemanske, Njira Lugogo, Richard J Martin, Deborah A Meyers, Joe Ramsdell, Christine A Sorkness, E Rand Sutherland, Stanley J Szefler, Stephen I Wasserman, Michael J Walter, Michael E Wechsler, Vernon M Chinchilli, Eugene R Bleecker
BACKGROUND: Long-acting beta-agonist (LABA) therapy improves symptoms in patients whose asthma is poorly controlled by an inhaled glucocorticoid alone. Alternative treatments for adults with uncontrolled asthma are needed. METHODS: In a three-way, double-blind, triple-dummy crossover trial involving 210 patients with asthma, we evaluated the addition of tiotropium bromide (a long-acting anticholinergic agent approved for the treatment of chronic obstructive pulmonary disease but not asthma) to an inhaled glucocorticoid, as compared with a doubling of the dose of the inhaled glucocorticoid (primary superiority comparison) or the addition of the LABA salmeterol (secondary noninferiority comparison)...
October 28, 2010: New England Journal of Medicine