Open and Closed Triple Inhaler Therapy in Patients with Uncontrolled Asthma

Adv Respir Med. 2023 Jul 4;91(4):288-300. doi: 10.3390/arm91040023.

Abstract

Long-acting muscarinic antagonists (LAMAs) are a class of inhalers that has recently been included as add-on therapy in the GINA guidelines, either in a single inhaler device with inhaled corticosteroids plus long-acting β2-agonists (ICS + LABA) (closed triple inhaler therapy) or in a separate one (open triple inhaler therapy). This review summarizes the existing evidence on the addition of LAMAs in patients with persistently uncontrolled asthma despite ICS + LABA treatment based on clinical efficacy in the reduction of asthma symptoms and exacerbations, the improvement in lung function, and its safety profile.

Keywords: GINA; ICS + LABA; LAMA; asthma; biomarker-guided treatment; closed triple inhaler therapy; review.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-2 Receptor Agonists* / therapeutic use
  • Asthma* / drug therapy
  • Drug Therapy, Combination
  • Humans
  • Muscarinic Antagonists / therapeutic use
  • Nebulizers and Vaporizers

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Muscarinic Antagonists
  • Adrenal Cortex Hormones

Grants and funding

This research received no external funding.