PRS5 TREATMENT PERSISTENCE AND EXACERBATIONS IN PATIENTS WITH ASTHMA INITIATING TREATMENT WITH INHALED CORTICOSTEROIDS AND LONG-ACTING BETA-ADRENERGIC AGONISTS (ICS/LABA): REAL-LIFE STUDY

Abstract

Asthma, a chronic inflammatory disease of the respiratory tract, presents with bronchial hyperresponsiveness and variable airflow obstruction. The objective of the study was to determine treatment persistence and exacerbations in patients initiating asthma treatment with various fixed-dose inhaled corticosteroid/long-acting beta-adrenergic agonist (ICS/LABA) combinations. An observational study was conducted by reviewing medical records. Patients aged ≥18 years were included who initiated treatment with ICS/LABA and met the inclusion/exclusion criteria. Patients were followed for one year. Study groups: fluticasone propionate/salmeterol (FP/SAL), beclomethasone/formoterol (BDP/FORM), budesonide/formoterol (BUD/FORM), fluticasone furoate/vilanterol (FF/VI) and fluticasone propionate/formoterol (FP/FORM). The main measurements were: treatment persistence, medication possession ratio (MPR) and exacerbations. Statistical significance was p <0.05. 3,203 patients were recruited, of which 31.1% were on FP/SAL, 28.6% BDP/FORM, 25.0% BUD/FORM, 8.2% FF/VI and 7.0% FP/FORM. The mean age was 52.2 years and 60.8% were female: 44.9% had moderate asthma. Treatment persistence was 61.7% (95% CI: 60.0-63.4%), and by study groups was: FP/SAL: 60.7%, BDP/FORM: 61.2 %, BUD/FORM: 60.3%, FF/VI: 66.7% and FP/FORM: 67.6% (p = 0.046). The MPR was: FP/SAL: 74.3%, BDP/FORM: 73.8%, BUD/FORM: 74.6%, FF/VI: 79.4% and FP/FORM: 80.6% (p = 0.028). The mortality rate was 2.9% and the percentage of exacerbations was: FP/SAL: 21.9%, BDP/FORM: 22.2%, BUD/FORM: 22.8%, FF/VI: 17.9% and FP/FORM: 16.0% (p = 0.036). Patients receiving FP/FORM and FF/VI had significantly greater treatment adherence (persistence, MPR) and lower rates of exacerbations. These differences could be due to the pharmacological properties of the drugs or other, unmeasured, factors.