A team of researchers from McMaster University and The Research Institute of St. Joe’s Hamilton has found that including a third drug to currently used dual-drug inhalers reduced acute exacerbations of chronic asthma in children, teenagers, and adults.

The researchers, who published their findings in the Journal of the American Medical Association (JAMA), looked at data from 20 randomized clinical trials that included nearly 12,000 patients.

The commonly used dual-drug asthma inhalers typically contain an inhaled corticosteroid (ICS) and a long-acting beta-adrenoceptor agonist (LABA). ICS helps reduce inflammation, while LABA acts as a bronchodilator.

The team found that adding a long-acting muscarinic antagonist (LAMA) to ICS-LABA not only reduced severe asthma exacerbations but also improved asthma control with no increase in side effects.

Lead author of the study Dr. Derek Chu said, “Our findings provide clear, high-quality evidence on the benefits and harms of triple therapy that will inform asthma care and should prompt revision of current asthma guidelines.”

Co-author of the study Lisa Kim, Clinical Scholar, Department of Medicine at McMaster, said, “If we can reach optimal control of patients’ asthma and reduce asthma exacerbation rates through the LAMA add-on therapy, patients may be able to avoid other treatments that carry a higher risk of adverse events, such as oral corticosteroids, or therapies that are substantially more expensive, such as biologics.”

LAMA inhalers are available in separate inhalers as well as in combination with ICS and LABA  

The researchers said both approaches to administering the LAMA work similarly.

In the United States, approximately 25 million people have asthma, which equals to about 1 in 13 Americans, including 8 percent of adults and 7 percent of children, according to the Asthma and Allergy Foundation of America (AAFA).

About 20 million American adults age 18 and over have asthma, says AAFA. Currently, there are more than 5 million children under the age of 18 with asthma.

Asthma is a condition in which your airways narrow and swell and may produce extra mucus, according to Mayo Clinic. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out, and shortness of breath.

The researchers also presented the study findings at the Advances in Asthma Therapies symposium, which is part of the American Thoracic Society’s annual conference. The article was published in Science Daily.