Asthma: new indication for Spiriva® (tiotropium) Respimat®* in the EU may offer millions of adults a significant advance in asthma care

Posted: 8 September 2014 |

Boehringer Ingelheim announced that the indication for Spiriva® (tiotropium) Respimat®* in asthma has been accepted by the regulatory authorities in the EU…

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Boehringer Ingelheim today announced that the indication for Spiriva® (tiotropium) Respimat®* in asthma has been accepted by the regulatory authorities in the EU.  Spiriva® Respimat® is indicated as an add-on maintenance bronchodilator treatment in adult patients with asthma who are currently treated with the maintenance combination of inhaled corticosteroids (≥800µg budesonide/day or equivalent) and long-acting beta2-agonists and who experienced one or more severe exacerbations in the previous year.

The new indication for Spiriva® Respimat® in asthma is based on the UniTinA-asthma® large-scale, Phase III clinical trial programme which investigated adults with asthma who continued to have symptoms despite taking at least ICS or ICS/LABA§ therapy.

New Phase III data from the UniTinA-asthma® programme presented today at The European Respiratory Society International Congress 2014 showed that Spiriva® Respimat® as an add-on treatment to ICS/LABA maintenance therapy:

  • Significantly improved asthma symptoms7 – patients were 68% more likely to improve asthma control compared to usual care alone8 

These new results add to existing evidence from the pivotal Phase III studies with patients on ICS/LABA therapy that demonstrated the addition of Spiriva® Respimat®:

  • Reduced the risk of patients having a severe asthma exacerbation by a fifth (21%)1
    • reduced the number of patients who experienced a severe  asthma exacerbation1
  •  Reduced the risk of patients’ asthma worsening by nearly a third (31%)1

The Phase III study results also showed that the safety of Spiriva® Respimat® is balanced as compared to placebo.1

Asthma is often seen as an easy to manage condition, and the misperception may exist that people with asthma symptoms can lead a normal life.  However, patients who experience asthma symptoms have about a six times greater chance of having a potentially life-threatening asthma attack over the next few weeks than those with minimal-to-no daytime symptoms.5 Their physical, social and professional lives can also be affected significantly.9

“We know that, despite taking current treatment options, almost half of those with asthma still experience symptoms,2,3,4 which can put them at a significantly increased risk of an asthma attack.5 These statistics clearly highlight the critical need for new and effective asthma treatments such as Spiriva® Respimat®,” said Professor David Halpin, Consultant Physician & Honorary Associate Professor, Royal Devon & Exeter Hospital.

“Over the past decade, not much has changed in the range of therapies that we can offer patients so this new indication for Spiriva® Respimat® is an important and welcome advance in the treatment of asthma.  Its unique mode of action in asthma provides physicians with a new option to help improve symptoms and reduce the number of patients who experience asthma exacerbations and worsenings that are not only frightening and very unpleasant, but can also be life-threatening,” Professor Halpin concluded.   

Spiriva® Respimat® is an inhaled, long-acting, anticholinergic maintenance treatment. It works by opening airways and helping to keep them open for at least 24 hours.10,11,12 There are currently no other long-acting anticholinergic bronchodilators indicated for the treatment of asthma. Spiriva® Respimat® is already approved for the treatment of chronic obstructive lung disease (COPD), with comprehensive clinical trial data from more than 230 tiotropium COPD trials.13

“With more than 90 years’ of experience in the field of respiratory diseases, Boehringer Ingelheim is committed to bringing new treatment options to physicians and patients, particularly in areas of high unmet medical need.  Asthma affects millions of patients across Europe,14 most people with asthma have low expectations of what can be achieved by asthma management and don’t realise that their condition can be improved,15” said Professor Klaus Dugi, Chief Medical Officer, Boehringer Ingelheim.

“The regulatory acceptance of Spiriva® Respimat® in asthma establishes a new class of inhaled asthma therapy. Our extensive studies have demonstrated that Spiriva® Respimat® can help to improve outcomes for adult patients with asthma who remain symptomatic despite current standard treatments.  In the clinical trials completed, Spiriva® Respimat® in asthma reduced healthcare utilisation, particularly in relation to the treatment of exacerbations,” Professor Dugi added.


  1. Kerstjens HAM, Engel M, Dahl R et al. Tiotropium in asthma poorly controlled with standard combination therapy. N Engl J Med 2012; 367 (13): 1198-1207
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  6. electronic Medicines Compendium (eMC),+250,+500+Accuhaler/ #AUTHDATE [accessed 10 July 2014]
  7. FitzGerald JM, Kerstjens HAM, Paggiaro P, et al. Once-daily tiotropium Respimat add-on to ICS±LABA improves control across asthma severities. ERS abstract No. 1894
  8. Data on file.  Boehringer Ingelheim, Ingelheim, Germany
  9. Braman SS. The Global Burden of Asthma. Chest 2006; 130; 4S-12S
  10. Casaburi R, Mahler DA, Jones PW, et al. A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease. Eur Respir J 2002;19:217-224.
  11. Celli B, ZuWallack R, Wang S, et al. Improvement in resting inspiratory capacity and hyperinflation with tiotropium in COPD patients with increased static lung volumes. Chest 2003; 124 (5): 1743-1748.
  12. Casaburi R, Kukafka D, Cooper CB, et al. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD. Chest 2005; 127: 809-817.
  13. Data on file.  Boehringer Ingelheim, Ingelheim, Germany
  14. European Lung White Book [last accessed 09/06/14].
  15. Haughney J, Barnes G, Partridge M, Cleland J. The Living & Breathing Study: a study of patients’ views of asthma and its treatment. Prim Care Respir J 2004; 13: 28-35

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