| Autor: |
Ji-Su Shim, Juhae Jin, Sae-Hoon Kim, Taehoon Lee, An-Soo Jang, Chan Sun Park, Jae-Woo Jung, Jae-Woo Kwon, Ji-Yong Moon, Min-Suk Yang, Jaechun Lee, Jeong-Hee Choi, Yoo Seob Shin, Hee-Kyoo Kim, Sujeong Kim, Joo-Hee Kim, Sang-Heon Cho, Young-Hee Nam, Sang-Hoon Kim, So Young Park, Gyu Young Hur, Sang-Ha Kim, Hye-Kyung Park, Hyun Jung Jin, Jae-Hyun Lee, Jung-Won Park, Ho Joo Yoon, Byoung Whui Choi, Young-Joo Cho, Min-Hye Kim, Tae-Bum Kim |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
The World Allergy Organization journal. 15(12) |
| ISSN: |
1939-4551 |
| Popis: |
Tiotropium, a long-acting muscarinic antagonist, is recommended for add-on therapy to inhaled corticosteroids (ICS)-long-acting beta 2 agonists (LABA) for severe asthma. However, real-world studies on the predictors of response to tiotropium are limited. We investigated the real-world use of tiotropium in asthmatic adult patients in Korea and we identified predictors of positive response to tiotropium add-on.We performed a multicenter, retrospective, cohort study using data from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA). We enrolled asthmatic participants who took ICS-LABA with at least 2 consecutive lung function tests at 3-month intervals. We compared tiotropium users and non-users, as well as tiotropium responders and non-responders to predict positive responses to tiotropium, defined as 1) increase in forced expiratory volume in 1 s (FEV1) ≥ 10% or 100 mL; and 2) increase in asthma control test (ACT) score ≥3 after 3 months of treatment.The study included 413 tiotropium users and 1756 tiotropium non-users. Tiotropium users had low baseline lung function and high exacerbation rate, suggesting more severe asthma. Clinical predictors for positive response to tiotropium add-on were 1) positive bronchodilator response (BDR) [odds ratio (OR) = 6.8, 95% confidence interval (CI): 1.6-47.4, P = 0.021] for FEV1 responders; 2) doctor-diagnosed asthma-chronic obstructive pulmonary disease overlap (ACO) [OR = 12.6, 95% CI: 1.8-161.5,The results of this study suggest that tiotropium add-on for uncontrolled asthma with ICS-LABA would be more effective in patients with positive BDR or ACO. Additionally, an increase in FEV1 following tiotropium may predict a lower risk of asthma exacerbation. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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