{"title":"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","authors":"Yumi Fujita, Toshihiro Shirai, Taisuke Akamatsu, Shogo Sakurai","doi":"10.1080/02770903.2025.2513053","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>FF/VI/UMEC improved SAD, and its improvement was correlated with improved asthma control in moderate to severe asthma and ACO patients.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1690-1697"},"PeriodicalIF":1.3000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Single-inhaler triple therapy improves small airway dysfunction in moderate to severe asthma and asthma-COPD overlap: a retrospective cohort study.\",\"authors\":\"Yumi Fujita, Toshihiro Shirai, Taisuke Akamatsu, Shogo Sakurai\",\"doi\":\"10.1080/02770903.2025.2513053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>FF/VI/UMEC improved SAD, and its improvement was correlated with improved asthma control in moderate to severe asthma and ACO patients.</p>\",\"PeriodicalId\":15076,\"journal\":{\"name\":\"Journal of Asthma\",\"volume\":\" \",\"pages\":\"1690-1697\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Asthma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02770903.2025.2513053\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Asthma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02770903.2025.2513053","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
Single-inhaler triple therapy improves small airway dysfunction in moderate to severe asthma and asthma-COPD overlap: a retrospective cohort study.
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.
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.