Use of ICS/LABA Combinations or LAMA Is Associated with a Lower Risk of Acute Exacerbation in Patients with Coexistent COPD and Asthma
Based on current guidelines, more research is urgently needed to guide appropriate treatment for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap. The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and ast...
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| Veröffentlicht in: | The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2018-11, Vol.6 (6), p.1927-1935.e3 |
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| container_end_page | 1935.e3 |
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| container_issue | 6 |
| container_start_page | 1927 |
| container_title | The journal of allergy and clinical immunology in practice (Cambridge, MA) |
| container_volume | 6 |
| creator | Su, Vincent Yi-Fong Yang, Kuang-Yao Yang, Yao-Hsu Tsai, Ying-Huang Perng, Diahn-Warng Su, Wei-Juin Chou, Kun-Ta Su, Kang-Cheng Yen, Yung-Feng Chen, Pau-Chung |
| description | Based on current guidelines, more research is urgently needed to guide appropriate treatment for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap.
The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and asthma.
Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to evaluate medication effects in patients with COPD and asthma. Patients diagnosed with both asthma and COPD between 1997 and 2012 were enrolled as the COPD + asthma cohort. The primary endpoint was acute exacerbation. The definitions of COPD and asthma were validated. The validation study confirmed the accuracy of definitions of COPD (86.2% sensitivity) and asthma (92.0% sensitivity).
The study included 251,398 patients with COPD + asthma and 514,522 patients with COPD alone, with a mean follow-up period of 9.85 years. After adjustment, hazard ratios (HRs) for long-acting muscarinic antagonist (LAMA) and inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations were lower (time-dependent model, 1 year: LAMA, HR 0.51, 95% confidence interval [CI] 0.49-0.54; ICS/LABA combinations, HR 0.61, 95% CI 0.60-0.62; all P < .0001) than were those for LABAs or ICSs in patients with COPD and asthma.
The use of LAMA or ICS/LABA combinations was associated with a lower risk of acute exacerbation in patients with COPD and asthma in this study. |
| doi_str_mv | 10.1016/j.jaip.2018.01.035 |
| format | Article |
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The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and asthma.
Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to evaluate medication effects in patients with COPD and asthma. Patients diagnosed with both asthma and COPD between 1997 and 2012 were enrolled as the COPD + asthma cohort. The primary endpoint was acute exacerbation. The definitions of COPD and asthma were validated. The validation study confirmed the accuracy of definitions of COPD (86.2% sensitivity) and asthma (92.0% sensitivity).
The study included 251,398 patients with COPD + asthma and 514,522 patients with COPD alone, with a mean follow-up period of 9.85 years. After adjustment, hazard ratios (HRs) for long-acting muscarinic antagonist (LAMA) and inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations were lower (time-dependent model, 1 year: LAMA, HR 0.51, 95% confidence interval [CI] 0.49-0.54; ICS/LABA combinations, HR 0.61, 95% CI 0.60-0.62; all P < .0001) than were those for LABAs or ICSs in patients with COPD and asthma.
The use of LAMA or ICS/LABA combinations was associated with a lower risk of acute exacerbation in patients with COPD and asthma in this study.</description><identifier>ISSN: 2213-2198</identifier><identifier>EISSN: 2213-2201</identifier><identifier>DOI: 10.1016/j.jaip.2018.01.035</identifier><identifier>PMID: 29432960</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acetylcholine receptors (muscarinic) ; ACO ; Asthma ; Asthma-COPD overlap ; Chronic obstructive pulmonary disease ; Clinical trials ; Comorbidity ; COPD ; Corticosteroids ; Exacerbations ; Gastroesophageal reflux ; Health insurance ; Heart failure ; Lung cancer ; Lung diseases ; Obstructive lung disease ; Patients ; Population studies ; Tuberculosis ; Urbanization</subject><ispartof>The journal of allergy and clinical immunology in practice (Cambridge, MA), 2018-11, Vol.6 (6), p.1927-1935.e3</ispartof><rights>2018 American Academy of Allergy, Asthma & Immunology</rights><rights>Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-ba9297db4e739eadb77a54922d82717354dd28f9af482c4ae1ce392e563a5d693</citedby><cites>FETCH-LOGICAL-c384t-ba9297db4e739eadb77a54922d82717354dd28f9af482c4ae1ce392e563a5d693</cites><orcidid>0000-0002-8080-0504</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29432960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Su, Vincent Yi-Fong</creatorcontrib><creatorcontrib>Yang, Kuang-Yao</creatorcontrib><creatorcontrib>Yang, Yao-Hsu</creatorcontrib><creatorcontrib>Tsai, Ying-Huang</creatorcontrib><creatorcontrib>Perng, Diahn-Warng</creatorcontrib><creatorcontrib>Su, Wei-Juin</creatorcontrib><creatorcontrib>Chou, Kun-Ta</creatorcontrib><creatorcontrib>Su, Kang-Cheng</creatorcontrib><creatorcontrib>Yen, Yung-Feng</creatorcontrib><creatorcontrib>Chen, Pau-Chung</creatorcontrib><title>Use of ICS/LABA Combinations or LAMA Is Associated with a Lower Risk of Acute Exacerbation in Patients with Coexistent COPD and Asthma</title><title>The journal of allergy and clinical immunology in practice (Cambridge, MA)</title><addtitle>J Allergy Clin Immunol Pract</addtitle><description>Based on current guidelines, more research is urgently needed to guide appropriate treatment for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap.
The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and asthma.
Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to evaluate medication effects in patients with COPD and asthma. Patients diagnosed with both asthma and COPD between 1997 and 2012 were enrolled as the COPD + asthma cohort. The primary endpoint was acute exacerbation. The definitions of COPD and asthma were validated. The validation study confirmed the accuracy of definitions of COPD (86.2% sensitivity) and asthma (92.0% sensitivity).
The study included 251,398 patients with COPD + asthma and 514,522 patients with COPD alone, with a mean follow-up period of 9.85 years. After adjustment, hazard ratios (HRs) for long-acting muscarinic antagonist (LAMA) and inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations were lower (time-dependent model, 1 year: LAMA, HR 0.51, 95% confidence interval [CI] 0.49-0.54; ICS/LABA combinations, HR 0.61, 95% CI 0.60-0.62; all P < .0001) than were those for LABAs or ICSs in patients with COPD and asthma.
The use of LAMA or ICS/LABA combinations was associated with a lower risk of acute exacerbation in patients with COPD and asthma in this study.</description><subject>Acetylcholine receptors (muscarinic)</subject><subject>ACO</subject><subject>Asthma</subject><subject>Asthma-COPD overlap</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clinical trials</subject><subject>Comorbidity</subject><subject>COPD</subject><subject>Corticosteroids</subject><subject>Exacerbations</subject><subject>Gastroesophageal reflux</subject><subject>Health insurance</subject><subject>Heart failure</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Obstructive lung disease</subject><subject>Patients</subject><subject>Population studies</subject><subject>Tuberculosis</subject><subject>Urbanization</subject><issn>2213-2198</issn><issn>2213-2201</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQxiMEolXpC3BAlrhw2dR_kjiWuIS0tCulagX0bDn2RHXYxIvt0PICPHe93ZYDh85lRqPf92k0X5a9JzgnmFQnYz4qu80pJnWOSY5Z-So7pJSwFU27188zEfVBdhzCiFPVhOMCv80OqCgYFRU-zP7eBEBuQOv2-0nXfGlQ66bezipaNwfkPOqaywatA2pCcNqqCAbd2XiLFOrcHXj0zYafO4NGLxHQ2b3S4PtHObIzuk4TzDHsNa2DextiWqD26voUqdkk33g7qXfZm0FtAhw_9aPs5uvZj_Zi1V2dr9umW2lWF3HVK0EFN30BnAlQpudclYWg1NSUE87KwhhaD0INRU11oYBoYIJCWTFVmkqwo-zT3nfr3a8FQpSTDRo2GzWDW4KkGBNBCsx5Qj_-h45u8XO6TlJCecUSWCaK7intXQgeBrn1dlL-jyRY7oKSo9wFJXdBSUxkCiqJPjxZL_0E5p_kOZYEfN4DkH7x24KXQac_ajDWg47SOPuS_wNUTaGJ</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Su, Vincent Yi-Fong</creator><creator>Yang, Kuang-Yao</creator><creator>Yang, Yao-Hsu</creator><creator>Tsai, Ying-Huang</creator><creator>Perng, Diahn-Warng</creator><creator>Su, Wei-Juin</creator><creator>Chou, Kun-Ta</creator><creator>Su, Kang-Cheng</creator><creator>Yen, Yung-Feng</creator><creator>Chen, Pau-Chung</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8080-0504</orcidid></search><sort><creationdate>201811</creationdate><title>Use of ICS/LABA Combinations or LAMA Is Associated with a Lower Risk of Acute Exacerbation in Patients with Coexistent COPD and Asthma</title><author>Su, Vincent Yi-Fong ; Yang, Kuang-Yao ; Yang, Yao-Hsu ; Tsai, Ying-Huang ; Perng, Diahn-Warng ; Su, Wei-Juin ; Chou, Kun-Ta ; Su, Kang-Cheng ; Yen, Yung-Feng ; Chen, Pau-Chung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-ba9297db4e739eadb77a54922d82717354dd28f9af482c4ae1ce392e563a5d693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acetylcholine receptors (muscarinic)</topic><topic>ACO</topic><topic>Asthma</topic><topic>Asthma-COPD overlap</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Clinical trials</topic><topic>Comorbidity</topic><topic>COPD</topic><topic>Corticosteroids</topic><topic>Exacerbations</topic><topic>Gastroesophageal reflux</topic><topic>Health insurance</topic><topic>Heart failure</topic><topic>Lung cancer</topic><topic>Lung diseases</topic><topic>Obstructive lung disease</topic><topic>Patients</topic><topic>Population studies</topic><topic>Tuberculosis</topic><topic>Urbanization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Su, Vincent Yi-Fong</creatorcontrib><creatorcontrib>Yang, Kuang-Yao</creatorcontrib><creatorcontrib>Yang, Yao-Hsu</creatorcontrib><creatorcontrib>Tsai, Ying-Huang</creatorcontrib><creatorcontrib>Perng, Diahn-Warng</creatorcontrib><creatorcontrib>Su, Wei-Juin</creatorcontrib><creatorcontrib>Chou, Kun-Ta</creatorcontrib><creatorcontrib>Su, Kang-Cheng</creatorcontrib><creatorcontrib>Yen, Yung-Feng</creatorcontrib><creatorcontrib>Chen, Pau-Chung</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Su, Vincent Yi-Fong</au><au>Yang, Kuang-Yao</au><au>Yang, Yao-Hsu</au><au>Tsai, Ying-Huang</au><au>Perng, Diahn-Warng</au><au>Su, Wei-Juin</au><au>Chou, Kun-Ta</au><au>Su, Kang-Cheng</au><au>Yen, Yung-Feng</au><au>Chen, Pau-Chung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of ICS/LABA Combinations or LAMA Is Associated with a Lower Risk of Acute Exacerbation in Patients with Coexistent COPD and Asthma</atitle><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle><addtitle>J Allergy Clin Immunol Pract</addtitle><date>2018-11</date><risdate>2018</risdate><volume>6</volume><issue>6</issue><spage>1927</spage><epage>1935.e3</epage><pages>1927-1935.e3</pages><issn>2213-2198</issn><eissn>2213-2201</eissn><abstract>Based on current guidelines, more research is urgently needed to guide appropriate treatment for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap.
The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and asthma.
Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to evaluate medication effects in patients with COPD and asthma. Patients diagnosed with both asthma and COPD between 1997 and 2012 were enrolled as the COPD + asthma cohort. The primary endpoint was acute exacerbation. The definitions of COPD and asthma were validated. The validation study confirmed the accuracy of definitions of COPD (86.2% sensitivity) and asthma (92.0% sensitivity).
The study included 251,398 patients with COPD + asthma and 514,522 patients with COPD alone, with a mean follow-up period of 9.85 years. After adjustment, hazard ratios (HRs) for long-acting muscarinic antagonist (LAMA) and inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations were lower (time-dependent model, 1 year: LAMA, HR 0.51, 95% confidence interval [CI] 0.49-0.54; ICS/LABA combinations, HR 0.61, 95% CI 0.60-0.62; all P < .0001) than were those for LABAs or ICSs in patients with COPD and asthma.
The use of LAMA or ICS/LABA combinations was associated with a lower risk of acute exacerbation in patients with COPD and asthma in this study.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29432960</pmid><doi>10.1016/j.jaip.2018.01.035</doi><orcidid>https://orcid.org/0000-0002-8080-0504</orcidid></addata></record> |
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| identifier | ISSN: 2213-2198 |
| ispartof | The journal of allergy and clinical immunology in practice (Cambridge, MA), 2018-11, Vol.6 (6), p.1927-1935.e3 |
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| source | Alma/SFX Local Collection |
| subjects | Acetylcholine receptors (muscarinic) ACO Asthma Asthma-COPD overlap Chronic obstructive pulmonary disease Clinical trials Comorbidity COPD Corticosteroids Exacerbations Gastroesophageal reflux Health insurance Heart failure Lung cancer Lung diseases Obstructive lung disease Patients Population studies Tuberculosis Urbanization |
| title | Use of ICS/LABA Combinations or LAMA Is Associated with a Lower Risk of Acute Exacerbation in Patients with Coexistent COPD and Asthma |
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