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Why is Breztri not for asthma?

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 15, 2025.

Official answer

by Drugs.com

Breztri is not used for asthma because it was made specifically to help people with COPD, which is a different lung condition. When scientists tested Breztri, they only looked at how well it worked for COPD, not asthma. Even though asthma and COPD both affect breathing, they need different kinds of treatments. The mix of medicines in Breztri has been shown to work for COPD, but it might not be the best choice for controlling asthma symptoms. That's why doctors don't prescribe Breztri for asthma - they have other medicines that work better for people with asthma.

Research has shown that one of the ingredients in Breztri, glycopyrrolate, is more useful for COPD than asthma because its mechanism of action involves blocking the effects of acetylcholine. While acetylcholine contributes to asthma symptoms, it's not considered a primary cause of the disease. In COPD, cholinergic mechanisms play a more dominant role in airway obstruction, which is why anticholinergics are more commonly used as primary treatments.

Asthma treatment guidelines, such as those from the Global Initiative for Asthma (GINA), recommend different medication combinations and stepwise approaches for the management of asthma, which does not include the specific triple therapy formulation in Breztri.

What is Breztri?

Breztri is a combination inhaler that contains 3 ingredients: budesonide (a corticosteroid), glycopyrrolate (a long-acting muscarinic antagonist), and formoterol (a long-acting beta agonist). Breztri is also known as Breztri aerosphere.

Breztri is only approved for use in adults with COPD (chronic obstructive pulmonary disease.

Breztri is not a rescue inhaler and cannot help if you have sudden breathing problems. Breztri is used twice a day as maintenance treatment for COPD. You should always keep a rescue inhaler, such as albuterol, with you while using Breztri.

Related questions

How does Breztri work?

Each of the 3 ingredients in Breztri has a different mechanism of action.

  • Budesonide helps to decrease inflammation in the lungs which can lead to breathing problems.
  • Glycopyrrolate blocks the effects of acetylcholine (a neurotransmitter) in the lungs, which allows the airways to relax and widen, making breathing easier.
  • Formoterol binds to and activates beta2-adrenergic receptors on the smooth muscle cells in the airways. This activation also allows the airways to relax and widen, making breathing easier. Formoterol has a long-lasting effect, typically lasting 12 hours or more, which provides sustained symptom relief throughout the day for COPD patients.
References
  • Breztri Prescribing Information. https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/9d44f9af-438a-448b-bb5c-dae506e17e49/9d44f9af-438a-448b-bb5c-dae506e17e49_viewable_rendition__v.pdf
  • Breztri Package Insert. https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/9d44f9af-438a-448b-bb5c-dae506e17e49/9d44f9af-438a-448b-bb5c-dae506e17e49_pi_med_guide_rendition__c.pdf

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