1. Clinical predictors of treatment response to tiotropium add-on therapy in adult asthmatic patients: From multicenter real-world cohort data in Korea
- Author
-
Ji-Su Shim, MD, PhD, Juhae Jin, MA, Sae-Hoon Kim, MD, PhD, Taehoon Lee, MD, PhD, An-Soo Jang, MD, PhD, Chan Sun Park, MD, PhD, Jae-Woo Jung, MD, PhD, Jae-Woo Kwon, MD, PhD, Ji-Yong Moon, MD, PhD, Min-Suk Yang, MD, PhD, Jaechun Lee, MD, PhD, Jeong-Hee Choi, MD, PhD, Yoo Seob Shin, MD, PhD, Hee-Kyoo Kim, MD, PhD, Sujeong Kim, MD, PhD, Joo-Hee Kim, MD, PhD, Sang-Heon Cho, MD, PhD, Young-Hee Nam, MD, PhD, Sang-Hoon Kim, MD, PhD, So Young Park, MD, PhD, Gyu Young Hur, MD, PhD, Sang-Ha Kim, MD, PhD, Hye-Kyung Park, MD, PhD, Hyun Jung Jin, MD, PhD, Jae-Hyun Lee, MD, PhD, Jung-Won Park, MD, PhD, Ho Joo Yoon, MD, PhD, Byoung Whui Choi, MD, PhD, Young-Joo Cho, MD, PhD, Min-Hye Kim, MD, PhD, and Tae-Bum Kim, MD, PhD
- Subjects
Tiotropium ,Muscarinic antagonists ,Asthma ,Treatment response ,Predictor ,Immunologic diseases. Allergy ,RC581-607 - 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
- Published
- 2022
- Full Text
- View/download PDF