Symptom control in patients with asthma using inhaled corticosteroids/long-acting β2-agonists (fluticasone furoate/vilanterol or budesonide/formoterol) in the US: a retrospective matched cohort study
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作者:
Averell, Carlyne M.
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GlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USAGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Averell, Carlyne M.
[1
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Laliberte, Francois
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Ltee, Grp Anal, Hlth Econ & Outcomes Res, Montreal, PQ, CanadaGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Laliberte, Francois
[2
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Germain, Guillaume
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Ltee, Grp Anal, Hlth Econ & Outcomes Res, Montreal, PQ, CanadaGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Germain, Guillaume
[2
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Duh, Mei Sheng
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Anal Grp Inc, Hlth Econ & Outcomes Res, Boston, MA USAGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Duh, Mei Sheng
[3
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Lima, Robson
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GlaxoSmithKline Plc, US Med Affairs, Res Triangle Pk, NC USAGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Lima, Robson
[4
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Mahendran, Malena
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Ltee, Grp Anal, Hlth Econ & Outcomes Res, Montreal, PQ, CanadaGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Mahendran, Malena
[2
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Slade, David J.
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GlaxoSmithKline Plc, Clin Sci, Res Triangle Pk, NC USAGlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Slade, David J.
[5
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机构:
[1] GlaxoSmithKline Plc, US Value Evidence & Outcomes, Res Triangle Pk, NC USA
Objective: Treatment with fluticasone furoate/vilanterol (FF/VI), an inhaled corticosteroid/long-acting beta(2)-agonist therapy, reduces the risk of severe asthma exacerbations and improves lung function and symptom control in patients with asthma. However, real-world data remain limited among asthma patients in the United States (US). Methods: This retrospective cohort study propensity score (PS) matched adult asthma patients initiating once-daily FF/VI 100/25 mcg with patients initiating twice-daily budesonide/formoterol (B/F) 160/4.5 mcg using a US claims database (January 1, 2015-December 31, 2018). Asthma control was measured by the mean number of short-acting beta(2)-agonist (SABA) canisters dispensed per patient-year (PPY) during follow-up. Time to first, and rates of, overall and severe asthma exacerbations were also measured. Results: After PS matching, 18,531 patients receiving FF/VI were matched to 18,531 patients receiving B/F. Mean SABA canisters dispensed PPY was significantly lower for FF/VI users compared with B/F users (FF/VI: 1.47, B/F: 1.64; p < 0.001). FF/VI use resulted in 13% significantly lower risk of having an overall asthma-related exacerbation and 22% lower risk of a severe exacerbation versus B/F use (overall exacerbation hazard ratio [HR] [95% confidence interval (CI)]: 0.87 [0.82-0.92], p < 0.001; severe exacerbation HR [95% CI]: 0.78 [0.63-0.97], p = 0.027). Asthma-related exacerbation rates per 100 patient-days were also significantly lower for the FF/VI group compared with the B/F group (overall: 0.0475 vs. 0.0558, p < 0.001; severe: 0.0026 vs. 0.0033, p = 0.020). Conclusions: In real-world practice, initiation of once-daily FF/VI 100/25 mcg in adults with asthma was associated with lower use of SABA and fewer asthma-related exacerbations, which may indicate better asthma control, when compared with use of twice-daily B/F 160/4.5 mcg.