For a study, it was determined that the use of anticholinergic drugs as a maintenance treatment for the chronic obstructive pulmonary disease (COPD) was widely recognized (COPD). The use of anticholinergic drugs in the treatment of moderate to severe asthma was becoming more popular. Researchers outlined the scientific evidence regarding the use of anticholinergic medication in asthma treatment. Early case reports and short trials investigated the use of the anticholinergic drug tiotropium bromide as an asthma maintenance medication. Several recent clinical trials that gave more evidence for the use of tiotropium as an add-on medication for asthma were included in the study. Based on changes in morning peak expiratory flow, tiotropium was shown to be more efficacious than doubling the dosage of an inhaled corticosteroid (ICS) and more effective than placebo (PEF). Two major international studies supported the use of tiotropium in a subpopulation of asthmatic patients who failed to establish control with an ICS and a long-acting 2 agonist in combination treatment (LABA).

In certain individuals with moderate to severe asthma who were uncontrolled on combination treatment with ICS and LABA, the long-acting anticholinergic drug tiotropium had been demonstrated to be useful as maintenance therapy. More research was needed to determine which phenotypic subgroup of individuals would benefit from tiotropium treatment.