Asthma is a chronic respiratory disease marked by persistent airway inflammation, hyperresponsiveness, and variable airflow limitation. Despite advancements in therapy, achieving optimal control remains challenging for many patients. Uncontrolled asthma, characterized by poor symptom control and frequent exacerbations, persists in patients receiving dual therapy with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA).

Long-acting muscarinic antagonists (LAMAs), such as tiotropium, have been incorporated into asthma management as an add-on therapy for patients with persistent symptoms. Tiotropium has demonstrated efficacy in improving lung function, reducing exacerbations, and enhancing symptom control. However, glycopyrronium, another LAMA, has not been extensively studied in the context of asthma, despite its favorable pharmacokinetics and efficacy in chronic obstructive pulmonary disease (COPD).

This study aims to bridge the gap in evidence by evaluating the efficacy of triple therapy comprising formoterol (LABA), budesonide (ICS), and glycopyrronium (LAMA) in Indian patients with uncontrolled asthma. By leveraging the unique pharmacological properties of glycopyrronium, we hypothesize that this combination will significantly improve asthma control as measured by the Asthma Control Questionnaire (ACQ-5) score. This investigation is crucial in addressing the unmet needs of asthma patients in the Indian context, where environmental and genetic factors may influence treatment outcomes.

We plan to assess whether triple therapy is beneficial in achieving asthma control in patients who have uncontrolled disease on ICS/LABA dual therapy.