title: The efficacy of tiotropium as a steroid-sparing agent in severe asthma.
abstract: People with severe asthma account for 5% to 10% of all asthmatic patients; however, this small group uses the majority of health care resources. Novel methods are needed to cope with the burden that this minority of patients places on the health care system. A severe asthma clinic patient, who was monitored through the University of Alberta's Virtual Asthma Clinic (Edmonton, Alberta) is presented. Despite optimization of his disease and individualized asthma education (provided by a certified asthma educator), the patient remained on oral glucocorticosteroids (OGS) to control his disease. Following optimization and stabilization, a further reduction in the dose of his OGS by the addition of the long-acting anticholinergic agent tiotropium bromide, was demonstrated. The role of tiotropium as a potential 'steroid-sparing agent' in severe refractory asthma is discussed, noting that if patients who are on OGS are not monitored for active inflammation, they may overuse the amount of prescribed systemic steroids, which can result in long-term steroid-related sequelae.
authors: Department of Medicine, University of Alberta, Edmonton, Canada.
authors: Anmol S
authors: AS
authors: Kapoor
authors: Sharla-Rae
authors: SR
authors: Olsen
authors: Cindy
authors: C
authors: O'Hara
authors: Lakshmi
authors: L
authors: Puttagunta
authors: Dilini
authors: D
authors: Vethanayagam
mesh_terms: D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D000069447:Tiotropium Bromide
chemical_list: D018680:Cholinergic Antagonists; D005938:Glucocorticoids; D012602:Scopolamine Derivatives; D011241:Prednisone; D000069447:Tiotropium Bromide