Long-acting Muscarinic Antagonists Proven Safe and Effective for Asthma in Children Aged 6–11, suggests study
Researchers identified that long-acting muscarinic antagonists (LAMA) were both safe and effective as an add-on therapy for moderate to severe asthma in children between the ages of 6 to 11. Although LAMA treatments like tiotropium have been routine in adolescents and adults, such options have been scarce in younger children. This study was published in the journal of Paediatric Respiratory Reviews by Gabriel B. and colleagues.
Since asthma in children tends to lead to compromised quality of life, recurrent hospitalizations, and side effects of medication, the demand for efficient and safe long-term management is of utmost importance. The present research addresses a significant gap by synthesizing available evidence regarding the use of LAMA in the pediatric age group and presents an understanding of its role in the control of asthma among the younger population.
The researchers systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) and observational studies of children under the age of 12 who were treated with LAMA add-on to ICS. Six studies—four RCTs and two observational studies—totalling 1,210 participants were included in the final analysis. Random-effects meta-analysis was employed for the estimation of outcomes measuring lung function, control of asthma, and adverse events. Subgroup analysis was additionally performed based on differences in LAMA dosage.
Key Findings
Pulmonary Function:
LAMA treatment markedly improved lung function:
Peak FEV1 rose by 86.16 mL (95% CI: 18.62–153.71; p < 0.01)
FEF25–75% rose by 0.2518 L (95% CI: 0.1971–0.3064; p < 0.01)
FVC did not change (MD 9.69 mL; 95% CI: –34.57 to 53.95; p = 0.67)
Asthma Control:
The Asthma Control Questionnaire reflected a mean difference of –0.07 (95% CI: –0.08 to –0.06; p < 0.01), which reflected better symptom control with LAMA.
Nighttime Symptoms and Rescue Medication:
There were no differences in nighttime awakenings or rescue medication use between the LAMA and control groups.
Safety and Adverse Events:
The use of LAMA in children was associated with fewer adverse events, RR: 0.88 (95% CI: 0.79–0.98; p = 0.021), verifying an acceptable safety profile.
LAMA treatment is safe and effective in children between 6–11 years with moderate to severe asthma when administered as add-on therapy to inhaled corticosteroids. The treatment markedly improves lung function and control of asthma with less side effects.
Reference:
Bolner, G., Rossi, Y. I., Dall’Acqua, J. C., Rossato, A. V., de Oliveira, F. D., Bolner, K., Fischer, G. B., Lukrafka, J. L., & Mocelin, H. T. (2025). Long-acting muscarinic antagonists as add-on treatment for asthma in children under age 12: a systematic review and meta-analysis. Paediatric Respiratory Reviews. https://doi.org/10.1016/j.prrv.2025.04.003
