A Randomized, Noninferiority Trial Comparing ICS + LABA with ICS + LABA + LAMA in Asthma-COPD Overlap (ACO) Treatment: The ACO Treatment with Optimal Medications (ATOMIC) Study
| Autor: | So-Young Park, Solmi Kim, Jung-Hyun Kim, Sae-Hoon Kim, Taehoon Lee, Sun-Young Yoon, Min-Hye Kim, Ji-Yong Moon, Min-Suk Yang, Jae-Woo Jung, Joo-Hee Kim, Jeong-Hee Choi, Chan Sun Park, Sujeong Kim, Jaechun Lee, Jae-Woo Kwon, Gyu Young Hur, Sang-Ha Kim, Hee-Kyoo Kim, Yoo Seob Shin, Sang-Hoon Kim, Young-Hee Nam, An-Soo Jang, Seo Young Park, Tae-Bum Kim, Woo-Jung Song, Hyouk-Soo Kwon, You Sook Cho, Hee-Bom Moon, Tae-Bum Ki, Bomi Seo, Byoung-Whui Choi, Young-Joo Cho, So Young Park, Hyun Jung Jin, Hye-Kyung Park, Sang Min Lee, Sung-Yoon Kang, Ga-Young Ban |
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| Rok vydání: | 2020 |
| Předmět: |
Vital capacity
medicine.medical_specialty Exacerbation Muscarinic Antagonists 03 medical and health sciences FEV1/FVC ratio Pulmonary Disease Chronic Obstructive 0302 clinical medicine Adrenal Cortex Hormones Internal medicine Administration Inhalation medicine Clinical endpoint Immunology and Allergy Humans 030212 general & internal medicine Adrenergic beta-2 Receptor Agonists Asthma COPD biology business.industry Lama medicine.disease biology.organism_classification Bronchodilator Agents 030228 respiratory system Exhaled nitric oxide Drug Therapy Combination business hormones hormone substitutes and hormone antagonists |
| Zdroj: | The journal of allergy and clinical immunology. In practice. 9(3) |
| ISSN: | 2213-2201 |
| Popis: | Background Current guidelines for the treatment of asthma and chronic obstructive pulmonary disease overlap (ACO) recommend initial treatment using inhaled corticosteroids (ICSs) plus 1 or more bronchodilators. Objective To clarify which therapeutic effect is better between the ICS + long-acting β2 agonist (LABA) and ICS + LABA + long-acting muscarinic antagonist (LAMA) treatment in patients with ACO. Methods We conducted a multicenter, 48-week, randomized, noninferiority trial. Patients with ACO were enrolled if they were treated with a moderate to high dose of ICS + LABA. In total, 303 patients were involved in the present trial, with 149 receiving ICS + LABA + LAMA. The primary end point was the time to first exacerbation. Secondary outcomes included changes in FEV1, forced vital capacity, FEV1/forced vital capacity ratio, asthma control, blood eosinophil count, and fractional exhaled nitric oxide. Results In the ICS + LABA treatment group, 29 of 154 patients (18.83%) experienced exacerbation, whereas 28 of 149 patients (18.79%) experienced exacerbation in the ICS + LABA + LAMA treatment group. The results of this noninferiority study were ultimately inconclusive (hazard ratio, 1.1; 95% CI, 0.66-1.84). However, the patients treated with the addition of LAMA showed significant improvements in FEV1 and forced vital capacity (P Conclusions Although this study was unable to conclude that ICS + LABA treatment is not inferior to ICS + LABA + LAMA in terms of exacerbation, it is obvious that the ICS + LABA + LAMA treatment group had improved lung function in ACO. |
| Databáze: | OpenAIRE |
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