Clinical predictors of treatment response to tiotropium add-on therapy in adult asthmatic patients: From multicenter real-world cohort data in Korea
DC Field | Value | Language |
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dc.contributor.author | Shim, Ji-Su | - |
dc.contributor.author | Jin, Juhae | - |
dc.contributor.author | Kim, Sae-Hoon | - |
dc.contributor.author | Lee, Taehoon | - |
dc.contributor.author | Jang, An-Soo | - |
dc.contributor.author | Park, Chan Sun | - |
dc.contributor.author | Jung, Jae-Woo | - |
dc.contributor.author | Kwon, Jae-Woo | - |
dc.contributor.author | Moon, Ji-Yong | - |
dc.contributor.author | Yang, Min-Suk | - |
dc.contributor.author | Lee, Jaechun | - |
dc.contributor.author | Choi, Jeong-Hee | - |
dc.contributor.author | Shin, Yoo Seob | - |
dc.contributor.author | Kim, Hee-Kyoo | - |
dc.contributor.author | Kim, Sujeong | - |
dc.contributor.author | Kim, Joo-Hee | - |
dc.contributor.author | Cho, Sang-Heon | - |
dc.contributor.author | Nam, Young-Hee | - |
dc.contributor.author | Kim, Sang-Hoon | - |
dc.contributor.author | Park, So Young | - |
dc.contributor.author | Hur, Gyu Young | - |
dc.contributor.author | Kim, Sang-Ha | - |
dc.contributor.author | Park, Hye-Kyung | - |
dc.contributor.author | Jin, Hyun Jung | - |
dc.contributor.author | Lee, Jae-Hyun | - |
dc.contributor.author | Park, Jung-Won | - |
dc.contributor.author | Yoon, Ho Joo | - |
dc.contributor.author | Choi, Byoung Whui | - |
dc.contributor.author | Cho, Young-Joo | - |
dc.contributor.author | Kim, Min-Hye | - |
dc.contributor.author | Kim, Tae-Bum | - |
dc.date.accessioned | 2023-02-07T03:40:01Z | - |
dc.date.available | 2023-02-07T03:40:01Z | - |
dc.date.issued | 2022-12 | - |
dc.identifier.issn | 1939-4551 | - |
dc.identifier.uri | https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62351 | - |
dc.description.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. | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | Lippincott Williams & Wilkins Ltd. | - |
dc.title | Clinical predictors of treatment response to tiotropium add-on therapy in adult asthmatic patients: From multicenter real-world cohort data in Korea | - |
dc.type | Article | - |
dc.publisher.location | 네델란드 | - |
dc.identifier.doi | 10.1016/j.waojou.2022.100720 | - |
dc.identifier.scopusid | 2-s2.0-85142432560 | - |
dc.identifier.wosid | 000904490300009 | - |
dc.identifier.bibliographicCitation | World Allergy Organization Journal, v.15, no.12 | - |
dc.citation.title | World Allergy Organization Journal | - |
dc.citation.volume | 15 | - |
dc.citation.number | 12 | - |
dc.type.docType | Article | - |
dc.description.isOpenAccess | Y | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Allergy | - |
dc.relation.journalResearchArea | Immunology | - |
dc.relation.journalWebOfScienceCategory | Allergy | - |
dc.relation.journalWebOfScienceCategory | Immunology | - |
dc.subject.keywordPlus | EXACERBATION | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordPlus | BROMIDE | - |
dc.subject.keywordAuthor | Tiotropium | - |
dc.subject.keywordAuthor | Muscarinic antagonists | - |
dc.subject.keywordAuthor | Asthma | - |
dc.subject.keywordAuthor | Treatment response | - |
dc.subject.keywordAuthor | Predictor | - |
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