Treatment of asthma in smokers: A questionnaire survey in Japanese clinical practice

Hiroaki Saito; Kimitake Tsuchiya; Sahoko Chiba; Tomoyuki Ogata; Reina Imase; Tamon Yagi; Yuka Mishima; Torahiko Jinta; Kazuhito Saito; Reiko Taki; Susumu Isogai; Yasuto Jin; Tsutomu Kawasaki; Ichiro Natsume; Yoshihiro Miyashita; Jun Takagiwa; Nobuo Ishiwata; Tomoshige Chiaki; Masato Kishi; Yoshikazu Tsukada; Motohisa Yamasaki; Naohiko Inase; Yasunari Miyazaki

doi:10.1016/j.resinv.2018.11.001

Treatment of asthma in smokers: A questionnaire survey in Japanese clinical practice

Respir Investig. 2019 Mar;57(2):126-132. doi: 10.1016/j.resinv.2018.11.001. Epub 2018 Dec 11.

Authors

Hiroaki Saito¹, Kimitake Tsuchiya², Sahoko Chiba³, Tomoyuki Ogata⁴, Reina Imase⁵, Tamon Yagi⁶, Yuka Mishima⁷, Torahiko Jinta⁸, Kazuhito Saito⁹, Reiko Taki¹⁰, Susumu Isogai¹¹, Yasuto Jin¹², Tsutomu Kawasaki¹³, Ichiro Natsume¹⁴, Yoshihiro Miyashita¹⁵, Jun Takagiwa¹⁶, Nobuo Ishiwata¹⁷, Tomoshige Chiaki¹⁸, Masato Kishi¹⁹, Yoshikazu Tsukada²⁰, Motohisa Yamasaki²¹, Naohiko Inase²², Yasunari Miyazaki²³

Affiliations

¹ Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: [email protected].
² Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: [email protected].
³ Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: [email protected].
⁴ Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan. Electronic address: [email protected].
⁵ Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan. Electronic address: [email protected].
⁶ Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan. Electronic address: [email protected].
⁷ Department of Respiratory Medicine, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan. Electronic address: [email protected].
⁸ Department of Respiratory Medicine, St. Luke׳s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan. Electronic address: [email protected].
⁹ Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura-shi, Ibaraki 300-0028, Japan. Electronic address: [email protected].
¹⁰ Department of Respiratory Medicine, Japanese Red Cross Musashino Hospital, 1-26-1 Kyonancho, Musashino-shi, Tokyo 180-8610, Japan. Electronic address: [email protected].
¹¹ Department of Respiratory Medicine, Ome Municipal General Hospital, 4-16-5 Higashiome, Ome-shi, Tokyo 198-0042, Japan. Electronic address: [email protected].
¹² Department of Respiratory Medicine, Hiratsuka Kyosai Hospital, 9-11 Oiwake, Hiratsuka-shi, Kanagawa 254-8502, Japan. Electronic address: [email protected].
¹³ Department of Respiratory Medicine, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama-shi, Kanagawa 231-8682, Japan. Electronic address: [email protected].
¹⁴ Department of Respiratory Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama-dori, Yokosuka-shi, Kanagawa 238-8558, Japan. Electronic address: [email protected].
¹⁵ Department of Respiratory Medicine, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu-shi, Yamanashi 400-8506, Japan. Electronic address: [email protected].
¹⁶ Department of Respiratory Medicine, Tokyo Kyosai Hospital, 2-3-8 Nakameguro, Meguro-ku, Tokyo 153-8934, Japan. Electronic address: [email protected].
¹⁷ Internal Medicine, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo 102-0074, Japan. Electronic address: [email protected].
¹⁸ Department of Respiratory Medicine, Hokushin General Hospital, 1-5-63 Nishi, Nakano-shi, Nagano 383-8505, Japan. Electronic address: [email protected].
¹⁹ Department of Respiratory Medicine, Mishima General Hospital, 2276 Aza-fujikubo, Yata, Mishima-shi, Shizuoka 411-0801, Japan. Electronic address: [email protected].
²⁰ Department of Respiratory Medicine, Soka Municipal Hospital, 2-21-1 Soka, Soka-shi, Saitama 340-8560, Japan. Electronic address: [email protected].
²¹ Department of Respiratory Medicine, Nitobe Memorial Nakano General Hospital, 4-59-16 Chuo, Nakano-ku, Tokyo 164-8607, Japan. Electronic address: [email protected].
²² Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: [email protected].
²³ Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: [email protected].

PMID: 30552072
DOI: 10.1016/j.resinv.2018.11.001

Abstract

Background: Cigarette smoking in patients with asthma leads to poor symptom control. As patients who are current smokers have been excluded from enrollment in many clinical trials on asthma, there are few reports on the treatment in current smokers with asthma. In this study, we aimed to assess how respiratory physicians manage asthma in current smokers in Japan.

Methods: Respiratory physicians in 16 Japanese hospitals answered a questionnaire on treatment for patients with asthma between December 2014 and February 2015. Medical records were reviewed for 1756 patients with asthma.

Results: The mean patient age was 61.1 years, and 62.9% of the patients were female. A total of 102 patients (5.8%) were current smokers, and 546 patients (31.1%) were former smokers. Long-acting muscarinic antagonists (LAMA) were prescribed more frequently for current smokers with asthma than for former smokers and never smokers with asthma (10.8% vs 4.6%, p = 0.01, 10.8% vs 3.8%, p < 0.01). In contrast, macrolides were prescribed more frequently for former smokers and never smokers with asthma than for current smokers with asthma (7.7% vs 1.0%, p = 0.01, 6.4% vs 1.0%, p = 0.03). Triple therapy, i.e., inhaled corticosteroids, long-acting beta agonists, and LAMA concomitantly, was prescribed for current smokers with asthma more frequently than for former smokers and never smokers with asthma (9.8% vs 4.0%, p = 0.01, 9.8% vs 3.3%, p < 0.01).

Conclusions: According to this survey, current smokers with asthma received more intensive therapy, including LAMA, than did former smokers with asthma.

Keywords: Asthma; Asthma treatment; Japan; Smoking; Triple therapy.

MeSH terms

Adrenal Cortex Hormones / administration & dosage
Adrenergic beta-Agonists / administration & dosage
Adult
Aged
Asthma / drug therapy*
Delayed-Action Preparations
Drug Therapy, Combination
Female
Humans
Japan / epidemiology
Macrolides / administration & dosage*
Male
Middle Aged
Muscarinic Antagonists / administration & dosage*
Prescriptions / statistics & numerical data*
Smokers*
Surveys and Questionnaires
Young Adult

Substances

Adrenal Cortex Hormones
Adrenergic beta-Agonists
Delayed-Action Preparations
Macrolides
Muscarinic Antagonists