title: Emerging therapeutic options for the treatment of patients with symptomatic asthma.
abstract: OBJECTIVE
  Asthma is a chronic inflammatory disorder of the airways with increasing worldwide prevalence. Despite treatment according to guidelines, a considerable proportion of patients with asthma remain symptomatic. Different potential therapeutic options for the treatment of these patients are currently in development and undergoing clinical trials, and it is important to regularly review their status.
  
  
  METHODS
  A search of ClinicalTrials.gov was performed and supported by a PubMed literature search and restricted to the previous 10 years to ensure currency of data. The results were manually filtered to identify relevant articles.
  
  
  METHODS
  Emerging therapies that are currently in phase 2 and 3 development include anti-interleukin agents (benralizumab, reslizumab, dupilumab, brodalumab, lebrikizumab, and mepolizumab), a chemoattractant receptor-homologous molecule expressed on a T-helper type 2 lymphocyte antagonist (OC000459), a phosphodiesterase-4 inhibitor (roflumilast), and long-acting muscarinic antagonists (glycopyrronium bromide, umeclidinium bromide, and tiotropium bromide).
  
  
  RESULTS
  The clinical trial program of the long-acting muscarinic antagonist tiotropium is currently the most advanced, with data available from different phase 2 and 3 studies. Results demonstrate that it is an efficacious add-on to at least inhaled corticosteroid maintenance therapy across severities of symptomatic asthma.
  
  
  CONCLUSIONS
  The results of ongoing and future studies will help to determine whether these emerging therapeutic options will help address the unmet need for improvement in asthma management.
authors.affiliation: McMaster University, Firestone Institute for Respiratory Health, Hamilton, Ontario, Canada. Electronic address: amcivor@stjosham.on.ca.
authors.forename: R Andrew
authors.initials: RA
authors.lastname: McIvor
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D007210:Indoleacetic Acids / Q000627:therapeutic use; D007378:Interleukins / Q000037:antagonists & inhibitors; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D058988:Phosphodiesterase 4 Inhibitors / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D000069447:Tiotropium Bromide / Q000627:therapeutic use*
chemical_list: C571151:(5-fluoro-2-methyl-3-quinolin-2-ylmethylindo-1-yl)acetic acid; D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D001993:Bronchodilator Agents; D007210:Indoleacetic Acids; D007378:Interleukins; D018727:Muscarinic Antagonists; D058988:Phosphodiesterase 4 Inhibitors; D011804:Quinolines; D000069447:Tiotropium Bromide