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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 | 박중원 | - |
dc.contributor.author | 이재현 | - |
dc.date.accessioned | 2023-03-03T02:54:06Z | - |
dc.date.available | 2023-03-03T02:54:06Z | - |
dc.date.issued | 2022-11 | - |
dc.identifier.issn | * | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/192922 | - |
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.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Elsevier Inc. | - |
dc.relation.isPartOf | WORLD ALLERGY ORGANIZATION JOURNAL | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
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.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Ji-Su Shim | - |
dc.contributor.googleauthor | Juhae Jin | - |
dc.contributor.googleauthor | Sae-Hoon Kim | - |
dc.contributor.googleauthor | Taehoon Lee | - |
dc.contributor.googleauthor | An-Soo Jang | - |
dc.contributor.googleauthor | Chan Sun Park | - |
dc.contributor.googleauthor | Jae-Woo Jung | - |
dc.contributor.googleauthor | Jae-Woo Kwon | - |
dc.contributor.googleauthor | Ji-Yong Moon | - |
dc.contributor.googleauthor | Min-Suk Yang | - |
dc.contributor.googleauthor | Jaechun Lee | - |
dc.contributor.googleauthor | Jeong-Hee Choi | - |
dc.contributor.googleauthor | Yoo Seob Shin | - |
dc.contributor.googleauthor | Hee-Kyoo Kim | - |
dc.contributor.googleauthor | Sujeong Kim | - |
dc.contributor.googleauthor | Joo-Hee Kim | - |
dc.contributor.googleauthor | Sang-Heon Cho | - |
dc.contributor.googleauthor | Young-Hee Nam | - |
dc.contributor.googleauthor | Sang-Hoon Kim | - |
dc.contributor.googleauthor | So Young Park | - |
dc.contributor.googleauthor | Gyu Young Hur | - |
dc.contributor.googleauthor | Sang-Ha Kim | - |
dc.contributor.googleauthor | Hye-Kyung Park | - |
dc.contributor.googleauthor | Hyun Jung Jin | - |
dc.contributor.googleauthor | Jae-Hyun Lee | - |
dc.contributor.googleauthor | Jung-Won Park | - |
dc.contributor.googleauthor | Ho Joo Yoon | - |
dc.contributor.googleauthor | Byoung Whui Choi | - |
dc.contributor.googleauthor | Young-Joo Cho | - |
dc.contributor.googleauthor | Min-Hye Kim | - |
dc.contributor.googleauthor | Tae-Bum Kim | - |
dc.identifier.doi | 10.1016/j.waojou.2022.100720 | - |
dc.contributor.localId | A01681 | - |
dc.contributor.localId | A03086 | - |
dc.relation.journalcode | J03985 | - |
dc.identifier.eissn | 1939-4551 | - |
dc.identifier.pmid | 36438190 | - |
dc.subject.keyword | Asthma | - |
dc.subject.keyword | Muscarinic antagonists | - |
dc.subject.keyword | Predictor | - |
dc.subject.keyword | Tiotropium | - |
dc.subject.keyword | Treatment response | - |
dc.contributor.alternativeName | Park, Jung Won | - |
dc.contributor.affiliatedAuthor | 박중원 | - |
dc.contributor.affiliatedAuthor | 이재현 | - |
dc.citation.volume | 15 | - |
dc.citation.number | 12 | - |
dc.citation.startPage | 100720 | - |
dc.identifier.bibliographicCitation | WORLD ALLERGY ORGANIZATION JOURNAL, Vol.15(12) : 100720, 2022-11 | - |
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