Tiotropium use in pediatric patients with asthma or chronic cough: A case series

摘要

Inhaled corticosteroids (ICS) are effective in the majority of children with asthma and are considered the mainstay of therapy. However, for those children who have inadequate control on low to medium doses of ICS, few options are available. Physicians, and parents, are often reluctant to increase the ICS dose due to concerns for systemic side effects. Despite maximal therapy, there are patients who still struggle with persistent symptoms. Therefore, new therapies are needed. Tiotropium bromide is a long-acting inhaled anticho-linergic agent that binds with high affinity to muscarinic receptors located in airway smooth muscle. The muscarinic M3 receptor subtype is thought to be the primary mediator of mucus secretion and bronchoconstriction.! Tiotropium decreases mucus production and acts as a bronchodilator by inhibiting smooth muscle contraction. Studies of tiotropium in animal models of asthma have demonstrated additional benefits including inhibition of airway remodeling and reduction of inflammation.