PMID- 37967963
OWN - NLM
STAT- MEDLINE
DCOM- 20231117
LR  - 20231117
IS  - 0021-4884 (Print)
IS  - 0021-4884 (Linking)
VI  - 72
IP  - 9
DP  - 2023
TI  - [CQ IN THE LONG-TERM MANAGEMENT OF ADULT ASTHMATIC PATIENTS WHO ARE NOT 
      ADEQUATELY CONTROLLED WITH INHALED CORTICOSTEROIDS MONOTHERAPY, WHICH IS MORE 
      BENEFICIAL: ADDING A LONG ACTING BETA2 AGONIST OR A LONG ACTING MUSCARINIC 
      ANTAGONIST?].
PG  - 1158-1173
LID - 10.15036/arerugi.72.1158 [doi]
AB  - Long-acting beta2-agonists (LABA) are preferred add-on treatment for adult 
      asthmatic patients whose symptoms cannot be controlled with inhaled 
      corticosteroids (ICS) alone. However, over the last decade, long-acting 
      muscarinic antagonists (LAMA) have gained approval for use in treating asthma, 
      and their efficacy is anticipated. Therefore, we conducted a systematic review to 
      investigate whether the addition of LABA or LAMA is more beneficial for the 
      long-term management of adult asthmatic patients poorly controlled on ICS 
      monotherapy. We extracted eight relevant randomized controlled trials 
      (represented in 18 articles) conducted by June 2022 form the corresponding 
      Cochrane review and additional searches through medical databases (CINAHL, 
      Cochrane Library, EMBASE, MEDLINE, PsycINFO, and ICHUSHI 
      (https://www.jamas.or.jp/)). While the LAMA add-on group showed a significantly 
      better improvement in some respiratory function tests, the difference between 
      groups did not exceed the minimum clinically important difference (MCID). On the 
      other hand, the Asthma Quality of Life Questionnaire, a quality of life metric, 
      was significantly higher in the LABA add-on group, but the difference also did 
      not surpass the MCID. Because no outcomes exceeded the MCID, we could not 
      determine whether adding LABA or LAMA on ICS is more beneficial in the long-term 
      management of adult asthmatic patients. Given that no significant differences 
      were found in the incidence of adverse events (including serious ones), when 
      specific adverse events associated with one treatment occur, switching to the 
      other treatment (from LABA to LAMA, or vice versa) can be considered as an 
      option.
FAU - Kimura, Yuya
AU  - Kimura Y
AD  - Clinical Research Center, National Hospital Organization Tokyo National Hospital.
FAU - Tomomatsu, Katsuyoshi
AU  - Tomomatsu K
AD  - Division of Pulmonary Medicine, Department of Medicine, Tokai University School 
      of Medicine.
FAU - Masaki, Katsunori
AU  - Masaki K
AD  - Division of Pulmonary Medicine, Department of Medicine, Keio University, School 
      of Medicine.
FAU - Mizumura, Kenji
AU  - Mizumura K
AD  - Division of Respiratory Medicine, Department of Internal Medicine, Nihon 
      University School of Medicine.
FAU - Wada, Yoshihisa
AU  - Wada Y
AD  - Pharmaceutical department, Osaka Habikino Medical Center.
FAU - Tanimura, Kazuya
AU  - Tanimura K
AD  - Department of Respiratory Medicine, Nara Medical University.
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PT  - Systematic Review
PL  - Japan
TA  - Arerugi
JT  - Arerugi = [Allergy]
JID - 0241212
RN  - 0 (Muscarinic Antagonists)
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
SB  - IM
MH  - Humans
MH  - Adult
MH  - Muscarinic Antagonists/therapeutic use
MH  - Quality of Life
MH  - Drug Therapy, Combination
MH  - Administration, Inhalation
MH  - *Asthma/drug therapy
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - World Health Organization
MH  - Adrenergic beta-2 Receptor Agonists/therapeutic use
MH  - *Pulmonary Disease, Chronic Obstructive
OTO - NOTNLM
OT  - adult asthma
OT  - long acting beta2 agonist
OT  - long acting muscarinic antagonist
OT  - systematic review
EDAT- 2023/11/16 00:42
MHDA- 2023/11/17 15:32
CRDT- 2023/11/15 20:44
PHST- 2023/11/17 15:32 [medline]
PHST- 2023/11/16 00:42 [pubmed]
PHST- 2023/11/15 20:44 [entrez]
AID - 10.15036/arerugi.72.1158 [doi]
PST - ppublish
SO  - Arerugi. 2023;72(9):1158-1173. doi: 10.15036/arerugi.72.1158.