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By blocking the muscarinic receptors expressed in the lung, LAMA improve lung function and reduce exacerbations in asthma patients who remained poorly controlled despite treatment with inhaled corticosteroids and long\u2010acting \u03b22 agonists. Asthma guidelines recommend LAMA as a third controller to be added on before the initiation of biologicals. In addition to bronchodilation, LAMA also exert anti\u2010inflammatory and anti\u2010fibrotic effects by inhibiting muscarinic receptors present in neutrophils, macrophages, fibroblasts and airway smooth muscle cells. Thus, besides bronchodilation, LAMA might provide additional therapeutic effects, thereby supporting an endotype\u2010driven approach to asthma management. The Position Paper, developed by the Asthma Section of the European Academy of Allergy and Clinical Immunology, discusses the main cholinergic pathways in the lung, reviews the findings of significant clinical trials and real\u2010life studies on LAMA use in asthma, examines the placement of these drugs in asthma clinical guidelines, and considers the potential for personalised medicine with LAMA in both adult and paediatric asthma patients.<\/jats:p>","DOI":"10.1111\/all.16436","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T05:44:20Z","timestamp":1734327860000},"page":"380-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Bronchodilator and Anti\u2010Inflammatory Effect of Long\u2010Acting Muscarinic Antagonists in Asthma: An\n                    <scp>EAACI<\/scp>\n                    Position Paper"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7994-364X","authenticated-orcid":false,"given":"I.","family":"Agache","sequence":"first","affiliation":[{"name":"Faculty of Medicine Transylvania University  Brasov Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2101-8843","authenticated-orcid":false,"given":"I. 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