D1.118 - The Use of Long-Acting Muscarinic Antagonist in the Treatment of Asthma: A Latin-American 2 Specialized Asthma Center Experience
Background
Asthma management follows a stepwise approach to control symptoms and minimize risks. For patients with uncontrolled asthma on step 4 and 5 therapies, LAMA add-on treatment, including tiotropium, has been shown to improve lung function and reduce exacerbations. Despite its inclusion in GINA 2021 guidelines, data on its real-world use and patient characteristics remain limited. This study aims to determine the prevalence of LAMA use and analyze the sociodemographic and clinical characteristics of patients receiving LAMA in a specialized severe asthma center.
Method
In this cross-sectional study, data on sociodemographic, phenotypic, and clinical characteristics of patients with asthma using step 4 and 5 medications followed up in our center for at least 1 year were obtained from file records. Whether the patients received add-on LAMA for at least 6 months was also noted.
Results
A total of 129 patients with asthma using steps 4 and 5 medications (female/male: 97/32) with a mean age of 50.84±12.42 years were included in the study. Seventy-nine (28.3%) patients (female/male: 60/19) with a mean age of 52.45±11.61 years used LAMA as add-on treatment; 28 (37.8%) at step 4 and 51 (24.8%) at step 5. In steps 4 and 5, there was no difference in age, sex, body mass index, smoking status, being allergic or eosinophilic, phenotype, and asthma onset between patients with and without add-on LAMA. Asthma control in the previous year was better and minimum FEV1 was lower in patients with LAMA than in those without in step 4 (p=0.001 and p=0.030, respectively). In step 5, the rate of being well-controlled was higher in those without add-on LAMA (p<0.001). The number of exacerbations in the previous year was higher and minimum and maximum FEV1 were lower in patients with add-on LAMA (p<0.001 and p<0.001, respectively).
Conclusion
Our study showed that add-on LAMA treatment could effectively increase asthma control in patients using step 4 medication, independent of baseline characteristics and asthma phenotype.
