Residual Dyspnea May Predict Small Airways Dysfunction and Poor Responsiveness to Single-Inhaler Triple Therapy in Asthmatic Patients

Autor: Ito K, Tajiri T, Nishiyama H, Kurokawa R, Yap JMG, Takeda N, Fukumitsu K, Kanemitsu Y, Fukuda S, Uemura T, Ohkubo H, Maeno K, Ito Y, Oguri T, Takemura M, Niimi A
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Asthma and Allergy, Vol Volume 15, Pp 1561-1568 (2022)
Druh dokumentu: article
ISSN: 1178-6965
74626868
Popis: Keima Ito,1 Tomoko Tajiri,1 Hirono Nishiyama,1 Ryota Kurokawa,1 Jenifer Maries Go Yap,1 Norihisa Takeda,1 Kensuke Fukumitsu,1 Yoshihiro Kanemitsu,1 Satoshi Fukuda,1 Takehiro Uemura,1 Hirotsugu Ohkubo,1 Ken Maeno,1 Yutaka Ito,1 Tetsuya Oguri,1,2 Masaya Takemura,1,2 Akio Niimi1 1Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; 2Department of Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanCorrespondence: Tomoko Tajiri, Email tomokot@med.nagoya-cu.ac.jpPurpose: Recently, single-inhaler triple therapy (SITT) has demonstrated efficacy in patients with uncontrolled asthma who were symptomatic despite treatment with inhaled corticosteroids/long-acting β 2 agonists. However, the characteristics of patients who benefit from SITT remain unclear in the real-world. The aim of this study was to examine the predictors of responsiveness to SITT in patients with asthma.Patients and Methods: A total of 45 patients with asthma who had regularly visited our respiratory clinic and were started on SITT from March 2019 to March 2021 were retrospectively analyzed. Patients’ demographic characteristics, residual respiratory symptoms, type 2 biomarkers, and lung function before SITT were assessed from the patients’ medical records. Predictors of responsiveness to four-week SITT were evaluated in these patients. The definition of responders was based on the physician-assessed global evaluation of treatment effectiveness.Results: Thirty-four (75%) of 45 patients were identified as responders to SITT. Non-responders showed significantly lower forced vital capacity (FVC) (%predicted) values, and complained of dyspnea more frequently than responders before SITT (p = 0.01 and p = 0.02, respectively). There were no significant differences in demographic characteristics and type 2 biomarkers between responders and non-responders. Clinical predictors of poor response to SITT were residual dyspnea (OR = 0.14, p = 0.02), low FVC (%predicted) values (OR = 1.05, p = 0.01), and FVC (%predicted) < 80% (OR = 0.11, p = 0.02). Multivariate analysis showed that poor response to SITT was associated with residual dyspnea before SITT (OR = 0.14, p = 0.02). On the other hand, patients with residual dyspnea had significantly lower FEF25– 75 (%predicted) values than patients without residual dyspnea before SITT (p = 0.04).Conclusion: Residual dyspnea, reflecting small airways dysfunction, may predict poor responsiveness to short-term SITT in patients with asthma.Keywords: single-inhaler triple therapy, long-acting muscarinic antagonists, asthma, small airways dysfunction, dyspnea
Databáze: Directory of Open Access Journals
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