Cited 0 times in Scipus Cited Count

Clinical predictors of treatment response to tiotropium add-on therapy in adult asthmatic patients: From multicenter real-world cohort data in Korea

Authors
Shim, JS | Jin, J | Kim, SH | Lee, T | Jang, AS | Park, CS | Jung, JW | Kwon, JW | Moon, JY | Yang, MS | Lee, J | Choi, JH | Shin, YS  | Kim, HK | Kim, S | Kim, JH | Cho, SH | Nam, YH | Kim, SH | Park, SY | Hur, GY | Kim, SH | Park, HK | Jin, HJ | Lee, JH | Park, JW | Yoon, HJ | Choi, BW | Cho, YJ | Kim, MH | Kim, TB | Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) Study Group
Citation
The World Allergy Organization journal, 15(12). : 100720-100720, 2022
Journal Title
The World Allergy Organization journal
ISSN
1939-4551
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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, P = 0.024], and 3) initial ACT score <20 [OR = 24.1, 95% CI: 5.45-158.8, P < 0.001] for ACT responders. FEV1 responders also showed a longer exacerbation-free period than those with no FEV1 increase (P = 0.014), yielding a hazard ratio for the first asthma exacerbation of 0.5 (95% CI: 0.3-0.9, P = 0.016). CONCLUSIONS: 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.
Keywords

DOI
10.1016/j.waojou.2022.100720
PMID
36438190
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
Ajou Authors
신, 유섭
Full Text Link
Files in This Item:
36438190.pdfDownload
Export

qrcode

해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse