Efficacy and safety of once-daily single-inhaler triple therapy in patients with inadequately controlled asthma: the CAPTAIN trial

Abstract

Inhaled corticosteroids (ICS) remain the cornerstone of treatment in asthmatic patients. In fact, many patients suffering from asthma are able to achieve good symptom control and avoid asthma exacerbations with a combination of moderate dose ICS and a long-acting β2-agonist (LABA). However, a significant number of patients require stepping up from moderate dose ICS/LABA to achieve good asthma control. While LABA are effective bronchodilators primarily due to their ability to relax airway smooth muscle (ASM) by exerting their effects via binding to the active site of β2-airway receptors, the mechanism of action of ICS in asthma is not well known, although they have shown to have a wide range of inhibitory effects on multiple cell types and mediators involved in inflammation and asthmatic response. The addition of tiotropium, a long-acting muscarinic antagonist (LAMA), which acts by blocking the bronchoconstriction effect of acetylcholine on M3 muscarinic receptors expressed in ASM, to the ICS/LABA combination has been shown to improve lung function and increase the time to first severe exacerbation in adult asthmatics [1]. Triple therapy with FF/UMEC/VI improved lung function in patients with moderate or severe uncontrolled asthma on ICS/LABA but did not lead to a reduction in moderate and/or severe exacerbations https://bit.ly/38UnuRW