{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T20:45:59Z","timestamp":1775508359618,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T00:00:00Z","timestamp":1454284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anticholinergic drug products are not part of the current treatment paradigm for asthma, despite their widespread availability for chronic obstructive pulmonary disease (COPD) and interest in their use for asthma. Published study results, mostly of short duration and primarily with ipratropium and tiotropium, have revealed inconsistent efficacy results. Consequently, the role of inhaled anticholinergic drugs in the treatment of asthma has been unclear. This commentary discusses and comments on data from five clinical trials in adults that were submitted by Boehringer Ingelheim to the U.S. Food and Drug Administration to support approval of tiotropium delivered by the Respimat device (Spiriva Respimat) for the treatment of asthma. These trials provided substantial evidence that supported the approval of Spiriva Respimat at a recommended dose of 2.5 \u03bcg once daily for asthma. Notably, in trials that evaluated two doses of tiotropium, 2.5 \u03bcg and 5 \u03bcg (the dose approved for COPD), pulmonary function measures for Spiriva Respimat 2.5 \u03bcg once daily were better overall than those obtained for the 5-\u03bcg once-daily dose, thus justifying selection of the lower dose for asthma. Spiriva Respimat represents the first new class of drug approved by the U.S. Food and Drug Administration for the treatment of asthma in more than a decade. The availability of Spiriva Respimat for asthma along with other novel therapies currently under development has the potential to impact asthma treatment guidelines.<\/jats:p>","DOI":"10.1513\/annalsats.201510-712ps","type":"journal-article","created":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T14:12:48Z","timestamp":1449670368000},"page":"173-179","source":"Crossref","is-referenced-by-count":9,"title":["Tiotropium Respimat Is Effective for the Treatment of Asthma at a Dose Lower Than That for Chronic Obstructive Pulmonary Disease"],"prefix":"10.1093","volume":"13","author":[{"given":"Stacy J.","family":"Chin","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Rheumatology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony G.","family":"Durmowicz","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Rheumatology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badrul A.","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Rheumatology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2016,2,1]]},"reference":[{"key":"2026020402571784300_bib1"},{"key":"2026020402571784300_bib2","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1056\/NEJM199810083391503","article-title":"Effect of nebulized ipratropium on the hospitalization rates of children with asthma","volume":"339","author":"Qureshi","year":"1998","journal-title":"N Engl J Med"},{"key":"2026020402571784300_bib3","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1056\/NEJMoa1008770","article-title":"Tiotropium bromide step-up therapy for adults with uncontrolled asthma","volume":"363","author":"Peters","year":"2010","journal-title":"N Engl J Med"},{"key":"2026020402571784300_bib4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/0002-9343(87)90378-0","article-title":"Nebulized anticholinergic and sympathomimetic treatment of asthma and chronic obstructive airways disease in the emergency room","volume":"82","author":"Rebuck","year":"1987","journal-title":"Am J Med"},{"key":"2026020402571784300_bib5","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1016\/S0140-6736(89)90126-8","article-title":"Nebulised salbutamol with and without ipratropium bromide in acute airflow obstruction","volume":"1","author":"O\u2019Driscoll","year":"1989","journal-title":"Lancet"},{"key":"2026020402571784300_bib6","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1378\/chest.110.3.611","article-title":"A comparison of ipratropium and albuterol vs albuterol alone for the treatment of acute asthma","volume":"110","author":"Karpel","year":"1996","journal-title":"Chest"},{"key":"2026020402571784300_bib7","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1378\/chest.111.2.311","article-title":"The clinical efficacy of combination nebulized anticholinergic and adrenergic bronchodilators vs nebulized adrenergic bronchodilator alone in acute asthma","volume":"111","author":"FitzGerald","year":"1997","journal-title":"Chest"},{"key":"2026020402571784300_bib8","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1001\/jama.2015.13277","article-title":"Anticholinergic vs long-acting \u03b2-agonist in combination with inhaled corticosteroids in black adults with asthma: the BELT randomized clinical trial","volume":"314","author":"Wechsler","year":"2015","journal-title":"JAMA"},{"key":"2026020402571784300_bib9"},{"key":"2026020402571784300_bib10"},{"key":"2026020402571784300_bib11","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.jaci.2011.04.039","article-title":"Tiotropium improves lung function in patients with severe uncontrolled asthma: a randomized controlled trial","volume":"128","author":"Kerstjens","year":"2011","journal-title":"J Allergy Clin Immunol"},{"key":"2026020402571784300_bib12","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1056\/NEJMoa1208606","article-title":"Tiotropium in asthma poorly controlled with standard combination therapy","volume":"367","author":"Kerstjens","year":"2012","journal-title":"N Engl J Med"},{"key":"2026020402571784300_bib13","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1378\/chest.14-1698","article-title":"What is the role of tiotropium in asthma? 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