Triple inhaled therapy in asthma: Beliefs, behaviours and doubts

Long-acting muscarinic antagonists (LAMA) in association with inhaled corticosteroids (ICS) plus long-acting beta-2 agonists (LABA) are recommended by the GINA report as further option in step 4 and first choice in step 5 treatment. Despite consistent evidence of its efficacy and safety, inhaled triple therapy (ITT) is still not largely used in patients with asthma. With the aim to explore belief and behaviours of asthma specialists, an ad hoc survey has been developed by a panel of Interasma Scientific Network (INESnet) experts and subsequently defined by two Delphi rounds among an international group of physicians. The questionnaire has been distributed through Interasma social media between June and September 2023. Besides a descriptive analysis, to assess the responses gathered from the questionnaire, Spearman's non-parametric statistical method was employed. Totally, three hundred fourteen questionnaires were completed. Clinicians' attitudes and behaviours toward timing and methodologies adopted in prescribing ITT, were analysed. 35.7 % specialists consider ITT as a relevant therapeutic option, 61.8 % that is second option after reaching high dose of ICS-LABA and 89.2 % agreed that optimization of inhaled therapy should be attempted before the use of biological drugs. Persistent flow limitation and high reversibility are considered predictive factors of response. Specialists consider ITT a resource in asthma management. Although its efficacy in decreasing exacerbation rate and improving lung function were well known, the survey revealed persistent uncertainties among clinicians in positioning it highlighting the need for further measures to effectively integrate research findings into day-to-day clinical practice.

Authors

Institutions

Publication Details

Journal
Pulmonary Pharmacology & Therapeutics
Published
2024-11-19
DOI
https://doi.org/10.1016/j.pupt.2024.102333
Citations
7
Primary Topic
Asthma and respiratory diseases
Type
article
Field-Weighted Citation Impact
2.29
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Triple inhaled therapy in asthma: Beliefs, behaviours and doubts

Bassam Mahboub, Nicola Scichilone, Marcello Mincarini, Denislava Nedeva et al.
7 citations
Pulmonary Pharmacology & Therapeutics
Asthma and respiratory diseases
2.29
article

Triple inhaled therapy in asthma: Beliefs, behaviours and doubts

Bassam Mahboub, Nicola Scichilone, Marcello Mincarini, Denislava Nedeva, Rasha El‐Owaidy, Sergio Zunino, Stefan D. Mihaicuta, Diego Bagnasco, Miodrag Filipovic, Edin Jusufović, Ignacio Javier Ansotegui, Giorgio Walter Canonica, Carmen Panaitescu, S Novakova, Herberto José Chong‐Neto, Paschalis Steiropoulos, Benedetta Bondi, András Bikov, Francisco Javier González‐Barcala, Rajiv Yadav, Alida Benfante, Plamena Novakova, L. DuBuske, Pierachille Santus, Francesca Lantieri, Jonathan A. Bernstein, Carlos Pereira Nunes, Alessandra Tomasello, F Braido, M Ferraris, Boulet Lp, I. Baiardini, Krzysztof Kowal, JC Virchow, Guidos Fogelbach G, Ivancevich Jc, Ricchiuto Fr
article en
7 citations

Abstract

Long-acting muscarinic antagonists (LAMA) in association with inhaled corticosteroids (ICS) plus long-acting beta-2 agonists (LABA) are recommended by the GINA report as further option in step 4 and first choice in step 5 treatment. Despite consistent evidence of its efficacy and safety, inhaled triple therapy (ITT) is still not largely used in patients with asthma. With the aim to explore belief and behaviours of asthma specialists, an ad hoc survey has been developed by a panel of Interasma Scientific Network (INESnet) experts and subsequently defined by two Delphi rounds among an international group of physicians. The questionnaire has been distributed through Interasma social media between June and September 2023. Besides a descriptive analysis, to assess the responses gathered from the questionnaire, Spearman's non-parametric statistical method was employed. Totally, three hundred fourteen questionnaires were completed. Clinicians' attitudes and behaviours toward timing and methodologies adopted in prescribing ITT, were analysed. 35.7 % specialists consider ITT as a relevant therapeutic option, 61.8 % that is second option after reaching high dose of ICS-LABA and 89.2 % agreed that optimization of inhaled therapy should be attempted before the use of biological drugs. Persistent flow limitation and high reversibility are considered predictive factors of response. Specialists consider ITT a resource in asthma management. Although its efficacy in decreasing exacerbation rate and improving lung function were well known, the survey revealed persistent uncertainties among clinicians in positioning it highlighting the need for further measures to effectively integrate research findings into day-to-day clinical practice.

Pulmonary Pharmacology & TherapeuticsVol. 87
George Washington University Hospital (US), Humanitas University (IT), University of Tuzla (BA), Medical University of Białystok (PL), Democritus University of Thrace (GR), Universidade de Santiago de Compostela (ES), Martin University (US), Hospital Italiano de Buenos Aires (AR), University of Sharjah (AE), Medical University of Sofia (BG), Victor Babeș University of Medicine and Pharmacy Timișoara (RO), Centro de Genética Clínica (PT), Manchester University NHS Foundation Trust (GB), Ain Shams University Hospital (EG), Hospital Quirónsalud Barcelona (ES), National Center for Tuberculosis and Lung Disease (GE), Spitalul Clinic Dr. Victor Babes (RO), Hospital de Clínicas Universidade Federal do Paraná (BR), Vietnam National Children's Hospital (VN), Ospedale Policlinico San Martino (IT), Instituto de Investigación Sanitaria de Santiago (ES), Wythenshawe Hospital (GB), ASST Fatebenefratelli Sacco (IT), Université Laval (CA), University of Rostock (DE), University of Cincinnati (US), All India Institute of Medical Sciences (IN), University of Genoa (IT), University of Palermo (IT), University of Cincinnati Medical Center (US), UCLouvain (BE)
Openalex Percentile: Top 11%
Asthma and respiratory diseases
2.29
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.