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A Randomized, Noninferiority Trial Comparing ICS + LABA with ICS + LABA + LAMA in Asthma-COPD Overlap (ACO) Treatment: The ACO Treatment with Optimal Medications (ATOMIC) Study

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dc.contributor.authorPark, SY-
dc.contributor.authorKim, S-
dc.contributor.authorKim, JH-
dc.contributor.authorKim, SH-
dc.contributor.authorLee, T-
dc.contributor.authorYoon, SY-
dc.contributor.authorKim, MH-
dc.contributor.authorMoon, JY-
dc.contributor.authorYang, MS-
dc.contributor.authorJung, JW-
dc.contributor.authorKim, JH-
dc.contributor.authorChoi, JH-
dc.contributor.authorPark, CS-
dc.contributor.authorKim, S-
dc.contributor.authorLee, J-
dc.contributor.authorKwon, JW-
dc.contributor.authorHur, GY-
dc.contributor.authorKim, SH-
dc.contributor.authorKim, HK-
dc.contributor.authorShin, YS-
dc.contributor.authorKim, SH-
dc.contributor.authorNam, YH-
dc.contributor.authorJang, AS-
dc.contributor.authorPark, SY-
dc.contributor.authorKim, TB-
dc.contributor.authorCohort for Reality and Evolution of Adult Asthma in Korea (COREA) Study Group-
dc.date.accessioned2023-01-05T03:03:13Z-
dc.date.available2023-01-05T03:03:13Z-
dc.date.issued2021-
dc.identifier.issn2213-2198-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23639-
dc.description.abstractBackground: Current guidelines for the treatment of asthma and chronic obstructive pulmonary disease overlap (ACO) recommend initial treatment using inhaled corticosteroids (ICSs) plus 1 or more bronchodilators. Objective: To clarify which therapeutic effect is better between the ICS + long-acting β2 agonist (LABA) and ICS + LABA + long-acting muscarinic antagonist (LAMA) treatment in patients with ACO. Methods: We conducted a multicenter, 48-week, randomized, noninferiority trial. Patients with ACO were enrolled if they were treated with a moderate to high dose of ICS + LABA. In total, 303 patients were involved in the present trial, with 149 receiving ICS + LABA + LAMA. The primary end point was the time to first exacerbation. Secondary outcomes included changes in FEV1, forced vital capacity, FEV1/forced vital capacity ratio, asthma control, blood eosinophil count, and fractional exhaled nitric oxide. Results: In the ICS + LABA treatment group, 29 of 154 patients (18.83%) experienced exacerbation, whereas 28 of 149 patients (18.79%) experienced exacerbation in the ICS + LABA + LAMA treatment group. The results of this noninferiority study were ultimately inconclusive (hazard ratio, 1.1; 95% CI, 0.66-1.84). However, the patients treated with the addition of LAMA showed significant improvements in FEV1 and forced vital capacity (P < .001). Asthma control did not improve in either group. Conclusions: Although this study was unable to conclude that ICS + LABA treatment is not inferior to ICS + LABA + LAMA in terms of exacerbation, it is obvious that the ICS + LABA + LAMA treatment group had improved lung function in ACO.-
dc.language.isoen-
dc.subject.MESHAdministration, Inhalation-
dc.subject.MESHAdrenal Cortex Hormones-
dc.subject.MESHAdrenergic beta-2 Receptor Agonists-
dc.subject.MESHAsthma-
dc.subject.MESHBronchodilator Agents-
dc.subject.MESHDrug Therapy, Combination-
dc.subject.MESHHumans-
dc.subject.MESHMuscarinic Antagonists-
dc.subject.MESHPulmonary Disease, Chronic Obstructive-
dc.titleA Randomized, Noninferiority Trial Comparing ICS + LABA with ICS + LABA + LAMA in Asthma-COPD Overlap (ACO) Treatment: The ACO Treatment with Optimal Medications (ATOMIC) Study-
dc.typeArticle-
dc.identifier.pmid33184024-
dc.subject.keywordAsthma-COPD overlap-
dc.subject.keywordICS-
dc.subject.keywordLABA-
dc.subject.keywordLAMA-
dc.subject.keywordTriple therapy-
dc.contributor.affiliatedAuthorShin, YS-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.jaip.2020.09.066-
dc.citation.titleThe journal of allergy and clinical immunology. In practice-
dc.citation.volume9-
dc.citation.number3-
dc.citation.date2021-
dc.citation.startPage1304-
dc.citation.endPage1311.e1-e2-
dc.identifier.bibliographicCitationThe journal of allergy and clinical immunology. In practice, 9(3). : 1304-1311.e1-e2, 2021-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn2213-2201-
dc.relation.journalidJ022132198-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
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