Single-inhaler triple therapy improves small airway dysfunction in moderate to severe asthma and asthma-COPD overlap: a retrospective cohort study.

IF 1.3 4区医学 Q3 ALLERGY

Journal of Asthma Pub Date : 2025-10-01 Epub Date: 2025-06-04 DOI:10.1080/02770903.2025.2513053

Yumi Fujita, Toshihiro Shirai, Taisuke Akamatsu, Shogo Sakurai

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引用次数: 0

Abstract

Background: Medium- or high-dose fluticasone furoate (FF)/vilanterol (VI)/umeclidinium (UMEC) is associated with an improvement in forced expiratory volume in one second (FEV1), a marker of large airway dysfunction. However, the effect of FF/VI/UMEC on small airway dysfunction (SAD) remains unknown.

Objective: To clarify the effect of FF/VI/UMEC on SAD in moderate to severe asthma and asthma-chronic obstructive pulmonary disease overlap (ACO) in a retrospective cohort study.

Methods: Subjects included 18 moderate to severe asthma and ACO patients who switched from inhaled corticosteroid/long-acting-β2 agonist (ICS/LABA) to FF/VI/UMEC. Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), blood eosinophil counts, total IgE, fractional exhaled nitric oxide, spirometry, and oscillometry were measured and compared before and after FF/VI/UMEC treatment.

Results: Markers of SAD, including forced vital capacity (FVC), forced expiratory flow at 25-75% of FVC, respiratory system reactance at 5 Hz (X5), resonant frequency, and low-frequency reactance area (AX), improved significantly after the induction of SITT, in addition to ACT, ACQ, FEV1, and FEV1/FVC. Improvements in FEV1, X5, and AX correlated with improvements in ACT, and improvements in FEV1 and FEV1/FVC correlated with improvements in ACQ.

Conclusion: FF/VI/UMEC improved SAD, and its improvement was correlated with improved asthma control in moderate to severe asthma and ACO patients.

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单吸入器三联疗法改善中重度哮喘和哮喘-慢性阻塞性肺病重叠患者的小气道功能障碍：一项回顾性队列研究

背景：中剂量或高剂量糠酸氟替卡松(FF)/维兰特罗(VI)/乌莫替啶（UMEC）与一秒钟用力呼气量（FEV1）的改善相关，FEV1是严重气道功能障碍的标志。然而，FF/VI/UMEC对小气道功能障碍（SAD）的影响尚不清楚。目的：通过回顾性队列研究，阐明FF/VI/UMEC对中重度哮喘和哮喘-慢性阻塞性肺疾病重叠（ACO）患者SAD的影响。方法：纳入18例由吸入皮质类固醇/长效β2激动剂（ICS/LABA）转换为FF/VI/UMEC的中重度哮喘和ACO患者。对FF/VI/UMEC治疗前后患者进行哮喘控制试验（ACT）、哮喘控制问卷（ACQ）、血嗜酸性粒细胞计数、总IgE、呼气一氧化氮分数、肺活量测定和震荡测定，并进行比较。结果：除ACT、ACQ、FEV1、FEV1/FVC外，SITT诱导后SAD指标包括用力肺活量（FVC）、用力呼气流量25-75%、5Hz呼吸系统电抗（X5）、共振频率、低频电抗面积（AX）均显著改善。FEV1、X5和AX的改善与ACT的改善相关，FEV1和FEV1/FVC的改善与ACQ的改善相关。结论：FF/VI/UMEC改善了中重度哮喘和ACO患者的SAD，其改善与哮喘控制改善相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Asthma 医学-过敏

CiteScore

4.00

自引率

5.30%

发文量

158

审稿时长

3-8 weeks

期刊介绍： Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.