Effect of high extrafine strength (HS) ICS-containing triple therapy on exacerbations in patients with severe asthma and persistent airflow limitation: Post-hoc analysis of the TRIGGER study
| Autor: | Walter Canonica, A. Vele, George Georges, Maxim Kots, Stefano Petruzzelli, David Singh, Florence Zuccaro, J. Christian Virchow |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Exacerbation business.industry Muscarinic antagonist Beclometasone dipropionate respiratory system medicine.disease Gastroenterology 03 medical and health sciences FEV1/FVC ratio 0302 clinical medicine 030228 respiratory system Internal medicine Post-hoc analysis medicine Salbutamol Glycopyrronium bromide 030212 general & internal medicine business Asthma medicine.drug |
| Zdroj: | Airway pharmacology and treatment. |
| DOI: | 10.1183/13993003.congress-2019.oa5339 |
| Popis: | Introduction: Persistent airflow limitation (PAL) may predict a positive clinical response to add-on long-acting muscarinic antagonist (LAMA) in asthmatics on inhaled corticosteroids and long-acting β2-receptor agonists (ICS/LABA) Objectives: We evaluated the effect of extrafine HS beclometasone dipropionate/formoterol fumarate/glycopyrronium bromide (BDP/FF/GB) on asthma exacerbations in a subset of patients with PAL Methods: TRIGGER was a phase III randomized, parallel group trial comparing 52-week treatment with BDP/FF/GB 800/24/50 µg/d to BDP/FF 800/24 µg/d via pressurized metered dose inhalers (pMDI) and open-label treatment consisting of BDP/FF plus tiotropium Respimat® 5 μg/d (TioR) in adult patients with uncontrolled asthma on high-dose ICS/LABA and a history of exacerbation in the past year. PAL criteria were FEV1 ≤80% of predicted normal and FEV1/FVC ≤0.7 after 400 μg salbutamol pMDI Results: 1437 subjects were randomized in 2:2:1 ratio; 880 (61.2%) met PAL criteria on BDP/FF/GB (n=357), BDP/FF (n=346), and BDP/FF+TioR (n=177), respectively. Treatment of this subgroup with BDP/FF/GB compared to BDP/FF resulted in a 25.9% and 31.8% reduction in annual moderate-severe and severe asthma exacerbations rates, respectively, (RR [95% CI] = 0.741 [0.611, 0.900], p=0.002; 0.682 [0.494; 0.940], p=0.019), vs. 12% and 20.5% reductions in the entire study population. There were no significant differences between BDP/FF/GB and BDP/FF+TioR. Conclusions: PAL is associated with a greater response to triple therapy with extrafine HS BDP/FF/GB in patients with asthma uncontrolled on high dose ICS/LABA |
| Databáze: | OpenAIRE |
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