دورية أكاديمية
Adding tiotropium or long-acting β2-agonists to inhaled corticosteroids: Asthma-related exacerbation risk and healthcare resource utilization.
| العنوان: | Adding tiotropium or long-acting β2-agonists to inhaled corticosteroids: Asthma-related exacerbation risk and healthcare resource utilization. |
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| المؤلفون: | Hanania NA; From the Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas., Settipane RA; Allergy and Asthma Center and Alpert Medical School of Brown University, East Providence, Rhode Island., Khoury S; Clinical Development and Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut., Shaikh A; Clinical Development and Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut., Dotiwala Z; eMAX Health, White Plains, New York., Casciano J; eMAX Health, Delray Beach, Florida; and., Foggs MB; Division of Allergy and Immunology, Advocate Health Care, Chicago, Illinois. |
| المصدر: | Allergy and asthma proceedings [Allergy Asthma Proc] 2023 Nov 13; Vol. 44 (6), pp. 413-421. |
| نوع المنشور: | Observational Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: OceanSide Publications Country of Publication: United States NLM ID: 9603640 Publication Model: Print Cited Medium: Internet ISSN: 1539-6304 (Electronic) Linking ISSN: 10885412 NLM ISO Abbreviation: Allergy Asthma Proc Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Providence, R.I. : OceanSide Publications, c1996- |
| مواضيع طبية MeSH: | Asthma*/drug therapy , Asthma*/epidemiology , Pulmonary Disease, Chronic Obstructive*, Humans ; Administration, Inhalation ; Adrenal Cortex Hormones/therapeutic use ; Bronchodilator Agents/therapeutic use ; Delivery of Health Care ; Drug Therapy, Combination ; Muscarinic Antagonists/therapeutic use ; Retrospective Studies ; Tiotropium Bromide/therapeutic use ; Child ; Adolescent ; Adult |
| مستخلص: | Background: Based on current clinical guidelines, long-acting β2-agonists (LABA) are frequently prescribed before long-acting muscarinic antagonists (LAMA) as an add-on to inhaled corticosteroids (ICS) in uncontrolled asthma. However, there is insufficient real-world evidence that supports this therapeutic approach. Objective: The objective was to compare asthma exacerbations and healthcare resource utilization in patients with asthma using the LAMA tiotropium bromide (Tio) or a LABA as an add-on to ICS (ICS + Tio or ICS/LABA) in a real-world setting. Methods: This retrospective, observational study included patients aged ≥12 years with asthma diagnoses identified in a U.S. longitudinal claims database (October 2015 to August 2020). The ICS + Tio and ICS/LABA cohorts were 1:2 propensity score matched for baseline variables. Outcomes were compared in the postmatched cohorts, and the risk of exacerbation was evaluated by using Kaplan-Meier curves. Results: After propensity score matching, there were 633 and 1266 patients in the ICS + Tio and ICS/LABA cohorts, respectively. The proportion of patients who experienced a severe or a moderate-or-severe exacerbation during follow-up was similar between the ICS + Tio versus ICS/LABA cohorts (4% versus 3%, p = 0.472, and 50% versus 45%, p = 0.050, respectively). The mean time to first severe (ICS + Tio 43.8 days versus ICS/LABA 49.4 days, p = 0.758) and moderate-or-severe exacerbation (ICS + Tio 65.8 days versus ICS/LABA 58.9 days, p = 0.474) was not statistically different between cohorts. The treatments had no effect on the risk of severe exacerbation, although it was 36% lower in ICS + Tio users than in ICS/LABA users (hazard ratio 0.64 [95% confidence interval, 0.22-1.84]). All-cause and asthma-related average monthly healthcare resource utilization were comparable between the treatments for hospitalizations and emergency department visits but were significantly greater in the ICS + Tio cohort than in the ICS/LABA cohort for asthma-related outpatient visits (p < 0.0001). Conclusion: This study provides real-world evidence that ICS + Tio may be a valid alternative when ICS/LABA cannot be used as first-line treatment for asthma maintenance therapy. |
| المشرفين على المادة: | 0 (Adrenal Cortex Hormones) 0 (Bronchodilator Agents) 0 (Muscarinic Antagonists) XX112XZP0J (Tiotropium Bromide) |
| تواريخ الأحداث: | Date Created: 20231103 Date Completed: 20231113 Latest Revision: 20231113 |
| رمز التحديث: | 20240628 |
| DOI: | 10.2500/aap.2023.44.230060 |
| PMID: | 37919843 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1539-6304 |
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| DOI: | 10.2500/aap.2023.44.230060 |