Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry
Özet
Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians’ preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients’ characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.
Anahtar kelimeler
Atıf için künye
Gemicioglu, B., Gokmen, D., Can, A., Sevinc, C., Oguzulgen, I. K., Soyyigit, S., Yakut, T., Havlucu, Y., Aydin, O., Buhari, G. K., Sozener, Z. C., Bulut, I., Beyaz, S., Orcen, C., Ozdemir, S. K., Keren, M., Damadoglu, E., Kalpaklioglu, A. F., Baccioglu, A., … Çelik, G. E. (2025). Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry. RESPIRATORY MEDICINE, 236. https://doi.org/10.1016/j.rmed.2024.107883
BibTeX
@article{gemicioglu2025-227146,
author = {Gemicioglu, Bilun and Gokmen, Derya and Can, Ali and Sevinc, Can and Oguzulgen, Ipek Kivilcim and Soyyigit, Sadan and Yakut, Tugce and Havlucu, Yavuz and Aydin, Omur and Buhari, Gozde Koycu and Sozener, Zeynep Celebi and Bulut, Ismet and Beyaz, Sengul and Orcen, Cihan and Ozdemir, Secil Kepil and Keren, Metin and Damadoglu, Ebru and Kalpaklioglu, Ayse Fusun and Baccioglu, Ayse and Yalim, Sumeyra Alan and Yilmaz, Insu and Kalkan, Ilkay Koca and Uysal, Mehmet Atilla and Ozgun Niksarlioglu, Elif Yelda and Kalyoncu, Ali Fuat and Karakaya, Gul and Erbay, Muge and Nayci, Sibel and Tepetam, Fatma Merve and Gelincik, Asli and Dirol, Hulya and Goksel, Ozlem and Karaoglanoglu, Selen and Erkekol, Ferda Oner and Isik, Sacide Rana and Yildiz, Fusun and Yavuz, Yasemin and Karadogan, Dilek and Bozkurt, Nurgul and Seker, Ummuhan and Basyigit, Ilknur and Baris, Serap Argun and Yılmazel Uçar, Elif and Erdogan, Tuba and Polatli, Mehmet and Ediger, Dane and Gunaydin, Fatma Esra and Turk, Murat and Pur, Leyla and Katran, Zeynep Yegin and Sekibag, Yonca and Aykac, Enes Furkan and Mungan, Dilsad and Gul, Ozcan and Cengiz, Ali and Akkurt, Bulent and Ozden, Seyma and Demir, Semra and Unal, Derya and Aslan, Ayse Feyza and Gumusburun, Reyhan and Bogatekin, Gulhan and Akten, Hatice Serpil and Inan, Sinem and Erdinc, Munevver and Ogus, Aliye Candan and Kavas, Murat and Yulug, Demet Polat and Cakmak, Mehmet Erdem and Kaya, Saltuk Bugra and Alpagat, Gulistan and Ozgur, Eylem Sercan and Uzun, Oguz and Gulen, Sule Tas and Pekbak, Gulseren and Kizilirmak, Deniz and Donmez, Halil and Arslan, Bahar and Cetin, Gulden Pacaci and Kara, Bilge Yilmaz and Dursun, Adile Berna and Karakis, Gulden Pasaoglu and Kendirlinan, Resat and Ozturk, Ayse Bilge and Simsek, Gokcen Omeroglu and Abadoglu, Oznur and Cerci, Pamir and Yucel, Taskin and Yorulmaz, Irfan and Tezcaner, Zahide Ciler and Tatar, Emel Cadalli and Suslu, Ahmet Emre and Ozer, Serdar and Dursun, Engin and Yorgancioglu, Arzu and Çelik, Gülfem Elif},
title = {Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry},
journal = {RESPIRATORY MEDICINE},
year = {2025},
volume = {236},
issn = {0954-6111},
doi = {10.1016/j.rmed.2024.107883},
url = {https://akademik.atauni.edu.tr/yayinlar/227146-factors-influencing-the-prescription-of-add-on-long-acting-muscarinic}
}