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Topic Title

  • Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma

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Research Review - Draft – Mar. 22, 2017

Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma

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This report is available in PDF only (Draft Report [996 kB]; Draft Appendixes [4.6 MB]). People using assistive technology may not be able to fully access information in these files. For additional assistance, please contact us.

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Purpose of the review

To assess the efficacy of intermittent inhaled corticosteroids (ICS) in different populations of patients with asthma and to assess the efficacy of added long-acting muscarinic antagonist patients with uncontrolled, persistent asthma.

Key Messages

  • Intermittent use of ICS during an upper respiratory tract infection in children less than 5 years old with recurrent wheezing decreases asthma exacerbations. 
  • Intermittent ICS use in patients 12 years and older with persistent asthma may be similar to ICS controller use. Using ICS and long-acting beta-agonist (LABA) together as controller and quick relief therapy reduces exacerbations compared to using ICS alone or with LABA as a controller only.
  • In patients at least 12 years old with uncontrolled, persistent asthma adding LAMA to ICS reduces exacerbations and improves lung function while adding LAMA to ICS and LABA controller improves asthma control and lung function. Adding LAMA to ICS instead of adding LABA impacts outcomes similarly.
  • Future research is needed to further explore the impact of intermittent ICS dosing on asthma outcomes in addition to studies more explicitly defining asthma severity and control, including reasons for a lack of control.

Now open for comment.