Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study
Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study
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DOI：
10.1007/s12325-020-01344-8
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发表时间：
2020-05-02
影响因子：
3.8
通讯作者：
Boxall, Naomi
中科院分区：
文献类型：
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作者：
Parimi, Mounika;Svedsater, Henrik;Boxall, Naomi
哮喘与重大经济负担相关。吸入皮质类固醇和长效β(2)-激动剂（ICS/LABA）联合疗法被认为是主要的治疗方法。我们通过比较英国哮喘患者开始使用糠酸氟替卡松/维兰特罗（FF/VI）与布地奈德/福莫特罗（BUD/FM）或二丙酸倍氯米松/福莫特罗（BDP/FM）的治疗持久性和依从性来描述ICS/LABAs的实际使用情况。方法对IQVIA医学研究数据库中的新用户活跃比较者数据库进行回顾性研究。对FF/VI与BUD/FM、FF/VI与BDP/FM进行倾向评分（PS）匹配。主要目的是比较患者的治疗持久性（到停药的时间），次要目标包括评估依从性（研究期间服药的平均天数比例[PDC]）和达到>= 50%和>= 80% PDC的患者比例。结果发现FF/VI （N = 966）、BUD/FM （N = 5931）和BDP/FM （N = 9607）的新用户，并进行ps匹配：FF/VI (N = 945) vs BUD/FM (N = 3272), FF/VI (N = 902) vs BDP/FM （N = 3465）。12个月时，治疗持续性为69% (FF/VI), 53% （BUD/FM）和57% （BDP/FM）。FF/VI治疗开始后12个月内停药的可能性比BUD/FM低35%，比BDP/FM低31%（均p < 0.001）。FF/VI的平均PDC高于BUD/FM （77.7 vs 72.4, p < 0.0001）和BDP/FM （78.2 vs 71.0, p < 0.0001）。FF/VI患者获得>= 50%和>= 80% PDC的几率大于BUD/FM和BDP/FM患者。在这项研究中，与开始使用BUD/FM或BDP/FM的患者相比，开始使用FF/VI的患者停止治疗的可能性较小，并且表现出更高的治疗依从性。
Introduction Asthma is associated with significant economic burden. Inhaled corticosteroid and long-acting beta(2)-agonist (ICS/LABA) combination therapies are considered mainstays of treatment. We describe real-world use of ICS/LABAs by comparing treatment persistence and adherence among patients with asthma in the United Kingdom initiating fluticasone furoate/vilanterol (FF/VI) versus budesonide/formoterol (BUD/FM) or beclometasone dipropionate/formoterol (BDP/FM). Methods A retrospective new-user active comparator database study was conducted in the IQVIA Medical Research Database. Propensity score (PS) matching was performed for FF/VI versus BUD/FM, and FF/VI versus BDP/FM. The primary objective was to compare patient treatment persistence (time to discontinuation), while secondary objectives included assessing adherence (mean proportion of days covered [PDC] with medication in the study period) and the proportions of patients achieving >= 50% and >= 80% PDC. Results New users of FF/VI (N = 966), BUD/FM (N = 5931) and BDP/FM (N = 9607) were identified and PS-matched: FF/VI (n = 945) versus BUD/FM (n = 3272), and FF/VI (n = 902) versus BDP/FM (n = 3465). At 12 months, treatment persistence was 69% (FF/VI), 53% (BUD/FM) and 57% (BDP/FM). The likelihood of treatment discontinuation within 12 months after initiation with FF/VI was 35% lower than with BUD/FM and 31% lower than for BDP/FM (both p < 0.001). Mean PDC was higher for FF/VI compared with BUD/FM (77.7 vs 72.4; p < 0.0001) and BDP/FM (78.2 vs 71.0; p < 0.0001). The odds of achieving >= 50% and >= 80% PDC were greater for FF/VI than for BUD/FM and BDP/FM. Conclusions In this study, patients who initiated FF/VI were less likely to discontinue treatment and showed greater treatment adherence versus patients who initiated BUD/FM or BDP/FM.