Tiotropium in Children with Asthma

Efficacy and Indications

• The American Academy of Allergy, Asthma, and Immunology recommends tiotropium as an add-on therapy in children aged 6 years and older with moderate to severe asthma that remains uncontrolled despite inhaled corticosteroids with or without additional controller medications 1
• Tiotropium was approved in the United States in 2015 for asthmatic patients aged 12 years and older at a once-daily 5 μg dose, as stated by the National Asthma Education and Prevention Program 1

Treatment Algorithm for Children with Asthma

First-line therapy:

• The National Heart, Lung, and Blood Institute recommends inhaled corticosteroids as the preferred long-term control medication for initiating therapy in children with asthma, as the benefits outweigh concerns about potential risks of growth velocity reduction or other possible adverse effects 2

When to consider tiotropium:

• The American College of Allergy, Asthma, and Immunology suggests considering tiotropium as an alternative to increasing inhaled corticosteroids dose to high-dose or adding a long-acting beta agonist in children with uncontrolled asthma 1, 2
• The Global Initiative for Asthma recommends tiotropium 5 μg as add-on to inhaled corticosteroids for adolescents aged 12-17 years with moderate symptomatic asthma, providing significant improvement in lung function 1