Clinical predictors of asthmatics in identifying subgroup requiring long-term tiotropium add-on therapy: a real-world study

• DOI: 10.21037/jtd.2019.09.22
• Publication Date: 2019-09-30T02:01:33Z
• Authors: Wen-Chien Cheng; Wei-Chih Liao; Biing-Ru Wu; Chih-Yu Chen; Meng-Fang Shen; Wei-Chun Chen; Te-Chun Hsia; Chih-Yen Tu; Chia-Hung Chen; Wu-Huei Hsu
• Keywords: Lama; Tiotropium bromide; Muscarinic antagonist; Combination therapy; Univariate analysis

According to several phase III studies, tiotropium [a long-acting muscarinic antagonist (LAMA)] is a well-tolerated add-on therapy inhaled corticosteroids (ICS) for asthmatics with or without the addition of beta2-agonists (LABAs). However, real-world studies based on clinical phenotypes predict long-term need as an are limited.This retrospective study conducted at single medical center in Taiwan from July 2016 2018. An asthma control test (ACT) applied uncontrolled evaluate effectiveness therapy. Asthmatic subgroups different and needing maintenance treatment identified. The defined improvement ACT score ≥3 points 3 months after (vs. baseline), while requirement dependency >1 year.The analyzed total 160 regardless low- medium-to-high-dose ICS plus LABA. One hundred twelve patients responded well (ACT increased points) tiotropium. These were further divided into two subgroups: one ≥1 year due patients' difficulties stepping down tiotropium; other <1 successful step-down according Global Initiative Asthma (GINA) score. All characteristics these groups collected analyzed. Univariate multivariate analyses showed that asthma-and-chronic obstructive pulmonary disease (COPD)-overlap (ACO), initial forced expiratory volume-one second (FEV1) % predicted <80%, body mass index (BMI) >30 kg/m2 predictors requiring therapy.Tiotropium effective asthmatics. Moreover, ACO, FEV1% BMI require control.