Why carry out the study?

GINA guidelines recommend increasing the dose of inhaled corticosteroids (ICS) as a step-up option for patients with inadequately controlled asthma on medium-dose ICS/long-acting beta-2 agonist (LABA) (GINA 2022 step 4). However, this may increase the risk of side effects.

Add-on long-acting muscarinic antagonists (LAMA) as a controller medication for patients with inadequately controlled asthma receiving medium-dose ICS/LABA (GINA 2022 step 4) was associated with improved lung function parameters and reduced exacerbation rates, with no new safety signals.

What was learned from the study?

Our findings support that LAMA add-on to medium-dose ICS/LABA is more beneficial than increasing the dose of ICS, and can be an important option for patients inadequately controlled at medium-dose ICS/LABA (GINA 2022 step 4).