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 (%FEV₁), 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.

Author Details

Authors

• Yoshihisa Ishiura^{1, 2}
• Masaki Fujimura³
• Noriyuki Ohkura⁴
• Johsuke Hara⁴
• Kazuo Kasahara⁴
• Nobuyasu Ishii¹
• Takeshi Tamaki¹
• Toshiki Shimizu¹
• Shosaku Nomura¹

Departments

• ¹ First Department of Internal Medicine, Kansai Medical University, Osaka,
• ² Respiratory Medicine, Toyama City Hospital, Toyama,
• ³ Respiratory Medicine, National Hospital Organization Nanao Hospital, Nanao, and
• ⁴ Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan

Address


Yoshihisa Ishiura, MD
First department of Internal Medicine
Kansai Medical University Medical Center
10-15 Fumizono-cho, Moriguchi, Osaka 570-8507, Japan
Email: ishiura-@
p2322.nsk.ne.jp

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