Inhaled Glucocorticoid with or without Tiotropium Bromide for Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome

Objective: To compare the efficacy of inhaled glucocorticoid with or without tiotropium bromide in the treatment of patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). Study Design: An experimental study. Place and Duration of Study: Department of Respiratory Medicine, Wuwei People's Hospital, Gansu Province, China, from October 2016 to October 2017. Methodology: A total of 86 ACOS patients were randomly divided into the control group and the observation group, with 43 cases in each group. Control group was given inhaled glucocorticoid. Observation group was treated with tiotropium bromide on the basis of the control group. The asthma control test (ACT) score, chronic obstructive pulmonary disease assessment test (CAT) score, serum high-sensitivity C-reactive protein (hs-CRP) and IL-6 levels were compared. Results: Before treatment, there was no significant difference in ACT score, CAT score, serum hs-CRP and IL-6 levels between the two groups (p=0.808, 0.612, 0.872 and 0.921, respectively). After treatment, ACT score in observation group was higher than that in control group (p <0.001). CAT score, serum hs-CRP, and IL-6 levels in observation group were lower than those in control group (all p <0.001). The incidence of adverse reactions was lower in observation group than that in control group (p=0.033). Conclusion: Compared with inhaled glucocorticoid, inhaled glucocorticoid combined with tiotropium bromide treatment can more effectively reduce the serum levels of hs-CRP and IL-6 and is beneficial to control the development of ACOS.