Effect of Triple Therapy in Patients with Asthma-COPD Overlap 

Overview

Journal Int J Clin Pharmacol Ther

Specialty Pharmacology

Date 2019 Jun 25

PMID 31232275

Citations 11

Authors

Yoshihisa Ishiura

Masaki Fujimura

Noriyuki Ohkura

Johsuke Hara

Kazuo Kasahara

Nobuyasu Ishii

Takeshi Tamaki

Toshiki Shimizu

Shosaku Nomura

Affiliations

Soon will be listed here.

Abstract

Objective: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is of increasing interest because ACO patients have significantly worse outcomes, leading to greater social and economic burdens compared with asthma or COPD alone. Some guidelines for ACO recommend triple therapy with inhaled corticosteroids, long-acting β2 agonists, and long-acting muscarinic antagonists. However, this approach is based on extrapolating data from patients with asthma or COPD alone. Therapeutic studies for ACO have not previously been conducted.

Materials And Methods: A 12-week, randomized, open-label cross-over pilot study was conducted in 17 ACO patients to evaluate the effect of umeclidinium (UMEC) 62.5 µg once-daily added to fluticasone furoate/vilanterol (FF/VI) 200/25 µg once-daily. A 4-week run-in, a first and a second 4-week treatment period were included. Respiratory function, respiratory impedance, fractional exhaled nitric oxide, COPD assessment test, and asthma control test scores were evaluated 0, 4, and 8 weeks after randomization.

Results: Mean values of post-bronchodilator forced expiratory volume in 1 second as a percentage of the predicted value (%FEV), after UMEC was added to FF/VI, were significantly higher than after the run-in (p < 0.01). Mean values of resonant frequency during inspiration (Fres), after UMEC was added to FF/VI, were significantly lower than after the run-in (p < 0.01).

Conclusion: Adding UMEC to FF/VI provides greater improvement in lung function, indicating that triple therapy is a suitable regular treatment for ACO.

Citing Articles

Retrospective Cohort Study of Elderly Users of Single- or Multiple-Inhaler Triple Therapy for the Treatment of Asthma in the USA.

Settipane R, Germain G, Laliberte F, Mahendran M, Hilts A, Duh M Pulm Ther. 2025; 11(1):81-100.

PMID: 39869154 PMC: 11861473. DOI: 10.1007/s41030-024-00285-9.

Open and Closed Triple Inhaler Therapy in Patients with Uncontrolled Asthma.

Kotoulas S, Tsiouprou I, Domvri K, Ntontsi P, Pataka A, Porpodis K Adv Respir Med. 2023; 91(4):288-300.

PMID: 37489386 PMC: 10366885. DOI: 10.3390/arm91040023.

Asthma-COPD Overlap in Clinical Practice (ACO_CP 2023): Toward Precision Medicine.

Alsayed A, Abu-Samak M, Alkhatib M J Pers Med. 2023; 13(4).

PMID: 37109063 PMC: 10146260. DOI: 10.3390/jpm13040677.

Tiotropium Add-On and Treatable Traits in Asthma-COPD Overlap: A Real-World Pilot Study.

Ishiura Y, Fujimura M, Ohkura N, Hara J, Nakahama K, Sawai Y J Asthma Allergy. 2022; 15:703-712.

PMID: 35651483 PMC: 9148922. DOI: 10.2147/JAA.S360260.

Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort: An Observational Cohort Study.

Buhr R, Barjaktarevic I, Quibrera P, Bateman L, Bleecker E, Couper D Am J Respir Crit Care Med. 2022; 206(5):554-562.

PMID: 35549640 PMC: 9716898. DOI: 10.1164/rccm.202201-0094OC.

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