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Asthma-related exacerbations, therapy switching, and therapy discontinuation: a comparison of 3 commonly used controller regimens.
Ann Allergy Asthma Immunol. 2005 Dec; 95(6):535-40.AA

Abstract

BACKGROUND

Asthma control is the goal of therapeutic interventions. In observational studies, the use of short-acting beta-agonists (SABAs) is a surrogate for symptoms and emergency department or hospital events for exacerbations.

OBJECTIVE

To compare asthma exacerbations, medication switch, and use of SABAs among 3 treatment cohorts: fluticasone propionate and salmeterol as a single inhaler (FSC), fluticasone and salmeterol as separate inhalers (FP + SAL), and fluticasone propionate alone (FP).

METHODS

Administrative claims data from approximately 10 million individuals from April 2000 to December 2002 were examined. Patients 15 years or older with claims for asthma, SABAs, and study medications were included in the study. Asthma-related medical and pharmacy claims were evaluated. Multivariate regression techniques were used to model the outcomes of interest, controlling for patient characteristics.

RESULTS

The odds of a hospitalization or emergency department event were significantly lower for the patients receiving FSC (n=1013) compared with those receiving FP (n=1130) (odds ratio, 0.75; 95% confidence interval, 0.61-0.93) and those receiving FP + SAL (n=271) (odds ratio, 0.69; 95% confidence interval, 0.51-0.95). Patients receiving FSC also had a significantly lower risk of switch or discontinuation of index medication and lower rates of postindex SABA use.

CONCLUSION

In this analysis, patients receiving FSC had lower rates of asthma-related symptoms and exacerbations as measured by SABA refills and hospitalization, respectively, when compared with patients receiving either FP or FP + SAL. This observational examination of medical and pharmacy claims data adds to the clinical reports that demonstrate the increased effectiveness of FSC when compared with FP or FP + SAL.

Authors+Show Affiliations

Sharp Rees Stealy Medical Group, San Diego, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16400892

Citation

O'Connor, Richard D., et al. "Asthma-related Exacerbations, Therapy Switching, and Therapy Discontinuation: a Comparison of 3 Commonly Used Controller Regimens." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 95, no. 6, 2005, pp. 535-40.
O'Connor RD, Rosenzweig JR, Stanford RH, et al. Asthma-related exacerbations, therapy switching, and therapy discontinuation: a comparison of 3 commonly used controller regimens. Ann Allergy Asthma Immunol. 2005;95(6):535-40.
O'Connor, R. D., Rosenzweig, J. R., Stanford, R. H., Gilmore, A. S., Ryskina, K. L., Legorreta, A. P., & Stempel, D. A. (2005). Asthma-related exacerbations, therapy switching, and therapy discontinuation: a comparison of 3 commonly used controller regimens. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 95(6), 535-40.
O'Connor RD, et al. Asthma-related Exacerbations, Therapy Switching, and Therapy Discontinuation: a Comparison of 3 Commonly Used Controller Regimens. Ann Allergy Asthma Immunol. 2005;95(6):535-40. PubMed PMID: 16400892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Asthma-related exacerbations, therapy switching, and therapy discontinuation: a comparison of 3 commonly used controller regimens. AU - O'Connor,Richard D, AU - Rosenzweig,Jacqueline R Carranza, AU - Stanford,Richard H, AU - Gilmore,Amanda S, AU - Ryskina,Kira L, AU - Legorreta,Antonio P, AU - Stempel,David A, PY - 2006/1/13/pubmed PY - 2006/1/27/medline PY - 2006/1/13/entrez SP - 535 EP - 40 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 95 IS - 6 N2 - BACKGROUND: Asthma control is the goal of therapeutic interventions. In observational studies, the use of short-acting beta-agonists (SABAs) is a surrogate for symptoms and emergency department or hospital events for exacerbations. OBJECTIVE: To compare asthma exacerbations, medication switch, and use of SABAs among 3 treatment cohorts: fluticasone propionate and salmeterol as a single inhaler (FSC), fluticasone and salmeterol as separate inhalers (FP + SAL), and fluticasone propionate alone (FP). METHODS: Administrative claims data from approximately 10 million individuals from April 2000 to December 2002 were examined. Patients 15 years or older with claims for asthma, SABAs, and study medications were included in the study. Asthma-related medical and pharmacy claims were evaluated. Multivariate regression techniques were used to model the outcomes of interest, controlling for patient characteristics. RESULTS: The odds of a hospitalization or emergency department event were significantly lower for the patients receiving FSC (n=1013) compared with those receiving FP (n=1130) (odds ratio, 0.75; 95% confidence interval, 0.61-0.93) and those receiving FP + SAL (n=271) (odds ratio, 0.69; 95% confidence interval, 0.51-0.95). Patients receiving FSC also had a significantly lower risk of switch or discontinuation of index medication and lower rates of postindex SABA use. CONCLUSION: In this analysis, patients receiving FSC had lower rates of asthma-related symptoms and exacerbations as measured by SABA refills and hospitalization, respectively, when compared with patients receiving either FP or FP + SAL. This observational examination of medical and pharmacy claims data adds to the clinical reports that demonstrate the increased effectiveness of FSC when compared with FP or FP + SAL. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/16400892/Asthma_related_exacerbations_therapy_switching_and_therapy_discontinuation:_a_comparison_of_3_commonly_used_controller_regimens_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(10)61015-0 DB - PRIME DP - Unbound Medicine ER -