Article
Author: Donmez, Halil ; Yildiz, Fusun ; Karadogan, Dilek ; Ucar, Elif Yilmazel ; Basyigit, Ilknur ; Gemicioglu, Bilun ; Kalpaklioglu, Ayse Fusun ; Kaya, Saltuk Bugra ; Arslan, Bahar ; Sekibag, Yonca ; Ozdemir, Secil Kepil ; Gokmen, Derya ; Cengiz, Ali ; Seker, Ummuhan ; Aslan, Ayse Feyza ; Karakis, Gulden Pasaoglu ; Ozgur, Eylem Sercan ; Nayci, Sibel ; Goksel, Ozlem ; Havlucu, Yavuz ; Yavuz, Yasemin ; Aykac, Enes Furkan ; Keren, Metin ; Ozturk, Ayse Bilge ; Ozden, Seyma ; Polatli, Mehmet ; Yilmaz, Insu ; Cetin, Gulden Pacaci ; Buhari, Gozde Koycu ; Dirol, Hulya ; Demir, Semra ; Ozgun Niksarlioglu, Elif Yelda ; Cakmak, Mehmet Erdem ; Baris, Serap Argun ; Kalkan, Ilkay Koca ; Unal, Derya ; Kavas, Murat ; Gumusburun, Reyhan ; Abadoglu, Oznur ; Ogus, Aliye Candan ; Yorgancioglu, Arzu ; Isik, Sacide Rana ; Çelik, Gülfem Elif ; Akten, Hatice Serpil ; Simsek, Gokcen Omeroglu ; Yorulmaz, Irfan ; Bogatekin, Gulhan ; Beyaz, Sengul ; Turk, Murat ; Ediger, Dane ; Bozkurt, Nurgul ; Erbay, Muge ; Sozener, Zeynep Celebi ; Yucel, Taskin ; Yalim, Sumeyra Alan ; Tatar, Emel Cadalli ; Dursun, Adile Berna ; Damadoglu, Ebru ; Karakaya, Gul ; Pekbak, Gulseren ; Ozer, Serdar ; Alpagat, Gulistan ; Mungan, Dilsad ; Dursun, Engin ; Uysal, Mehmet Atilla ; Yulug, Demet Polat ; Pur, Leyla ; Gul, Ozcan ; Baccioglu, Ayse ; Cerci, Pamir ; Tezcaner, Zahide Ciler ; Gelincik, Asli ; Erkekol, Ferda Oner ; Can, Ali ; Erdinc, Munevver ; Gulen, Sule Tas ; Sevinc, Can ; Aydin, Omur ; Akkurt, Bulent ; Gunaydin, Fatma Esra ; Oguzulgen, Ipek Kivilcim ; Tepetam, Fatma Merve ; Bulut, Ismet ; Kara, Bilge Yilmaz ; Suslu, Ahmet Emre ; Erdogan, Tuba ; Orcen, Cihan ; Katran, Zeynep Yegin ; Yakut, Tugce ; Inan, Sinem ; Karaoglanoglu, Selen ; Soyyigit, Sadan ; Kendirlinan, Resat ; Kalyoncu, Ali Fuat ; Kizilirmak, Deniz ; Uzun, Oguz
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.