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Risk of asthma exacerbation, asthma-related health care utilization and costs, and adherence to controller therapy in patients with asthma receiving fluticasone propionate/salmeterol inhalation powder 100 μg/50 μg versus mometasone furoate inhalation powder.
J Asthma. 2013 Apr; 50(3):287-95.JA

Abstract

OBJECTIVE

National asthma treatment guidelines recommend low/medium-dose inhaled corticosteroids (ICSs) as initial therapy in mild asthma patients. However, low doses of a fixed-dose combination of ICS and long-acting β-agonists are sometimes used. This study compares asthma-related outcomes and health care utilization and costs in clinical practice in patients starting fluticasone propionate 100 μg and salmeterol 50 μg via Diskus (FSC) or mometasone furoate (MF).

METHODS

A retrospective cohort study was conducted to compare asthma-related outcomes in asthma patients who received FSC or MF, using a large health insurance claims dataset spanning January 2004-December 2008. Patients with ≥1 claim with an asthma ICD-9-CM diagnosis code and ≥2 FSC or MF prescriptions were included, stratified into FSC or MF groups by study drug received first and matched using propensity score.

RESULTS

A total of 18,283 patients met inclusion criteria (14,044 FSC and 4239 MF); 3799 matched pairs were identified (mean follow-up: FSC 548 days, MF 537 days). FSC patients had lower risk of asthma-related exacerbation (Hazard ratio = 0.88, 95% CI 0.81-0.95, p = .002), defined as either asthma-related emergency department (ED) visits/hospitalizations or receipt of systemic corticosteroids (SCSs); fewer SCS claims (mean 0.28 vs. 0.33, p = .021); and fewer asthma-related physician office (PO) and hospital outpatient (HO) visits (mean 1.17 vs. 1.63, p < .001). However, asthma-related ED visits were higher with FSC (p = .004), and FSC patients had higher total costs of asthma-related health care ($953 vs. $862, p = .002).

CONCLUSIONS

In asthma patients initiating ICS therapy, MF had lower asthma-related ED visits. However, FSC may reduce the use of SCS and asthma-related PO/HO visits.

Authors+Show Affiliations

Policy Analysis Inc., Brookline, MA 02445, USA. mhagiwara@pai2.comNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23305687

Citation

Hagiwara, May, et al. "Risk of Asthma Exacerbation, Asthma-related Health Care Utilization and Costs, and Adherence to Controller Therapy in Patients With Asthma Receiving Fluticasone Propionate/salmeterol Inhalation Powder 100 Μg/50 Μg Versus Mometasone Furoate Inhalation Powder." The Journal of Asthma : Official Journal of the Association for the Care of Asthma, vol. 50, no. 3, 2013, pp. 287-95.
Hagiwara M, Delea TE, Stanford RH. Risk of asthma exacerbation, asthma-related health care utilization and costs, and adherence to controller therapy in patients with asthma receiving fluticasone propionate/salmeterol inhalation powder 100 μg/50 μg versus mometasone furoate inhalation powder. J Asthma. 2013;50(3):287-95.
Hagiwara, M., Delea, T. E., & Stanford, R. H. (2013). Risk of asthma exacerbation, asthma-related health care utilization and costs, and adherence to controller therapy in patients with asthma receiving fluticasone propionate/salmeterol inhalation powder 100 μg/50 μg versus mometasone furoate inhalation powder. The Journal of Asthma : Official Journal of the Association for the Care of Asthma, 50(3), 287-95. https://doi.org/10.3109/02770903.2012.754028
Hagiwara M, Delea TE, Stanford RH. Risk of Asthma Exacerbation, Asthma-related Health Care Utilization and Costs, and Adherence to Controller Therapy in Patients With Asthma Receiving Fluticasone Propionate/salmeterol Inhalation Powder 100 Μg/50 Μg Versus Mometasone Furoate Inhalation Powder. J Asthma. 2013;50(3):287-95. PubMed PMID: 23305687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of asthma exacerbation, asthma-related health care utilization and costs, and adherence to controller therapy in patients with asthma receiving fluticasone propionate/salmeterol inhalation powder 100 μg/50 μg versus mometasone furoate inhalation powder. AU - Hagiwara,May, AU - Delea,Thomas E, AU - Stanford,Richard H, Y1 - 2013/01/10/ PY - 2013/1/12/entrez PY - 2013/1/12/pubmed PY - 2013/7/3/medline SP - 287 EP - 95 JF - The Journal of asthma : official journal of the Association for the Care of Asthma JO - J Asthma VL - 50 IS - 3 N2 - OBJECTIVE: National asthma treatment guidelines recommend low/medium-dose inhaled corticosteroids (ICSs) as initial therapy in mild asthma patients. However, low doses of a fixed-dose combination of ICS and long-acting β-agonists are sometimes used. This study compares asthma-related outcomes and health care utilization and costs in clinical practice in patients starting fluticasone propionate 100 μg and salmeterol 50 μg via Diskus (FSC) or mometasone furoate (MF). METHODS: A retrospective cohort study was conducted to compare asthma-related outcomes in asthma patients who received FSC or MF, using a large health insurance claims dataset spanning January 2004-December 2008. Patients with ≥1 claim with an asthma ICD-9-CM diagnosis code and ≥2 FSC or MF prescriptions were included, stratified into FSC or MF groups by study drug received first and matched using propensity score. RESULTS: A total of 18,283 patients met inclusion criteria (14,044 FSC and 4239 MF); 3799 matched pairs were identified (mean follow-up: FSC 548 days, MF 537 days). FSC patients had lower risk of asthma-related exacerbation (Hazard ratio = 0.88, 95% CI 0.81-0.95, p = .002), defined as either asthma-related emergency department (ED) visits/hospitalizations or receipt of systemic corticosteroids (SCSs); fewer SCS claims (mean 0.28 vs. 0.33, p = .021); and fewer asthma-related physician office (PO) and hospital outpatient (HO) visits (mean 1.17 vs. 1.63, p < .001). However, asthma-related ED visits were higher with FSC (p = .004), and FSC patients had higher total costs of asthma-related health care ($953 vs. $862, p = .002). CONCLUSIONS: In asthma patients initiating ICS therapy, MF had lower asthma-related ED visits. However, FSC may reduce the use of SCS and asthma-related PO/HO visits. SN - 1532-4303 UR - https://www.unboundmedicine.com/medline/citation/23305687/Risk_of_asthma_exacerbation_asthma_related_health_care_utilization_and_costs_and_adherence_to_controller_therapy_in_patients_with_asthma_receiving_fluticasone_propionate/salmeterol_inhalation_powder_100_μg/50_μg_versus_mometasone_furoate_inhalation_powder_ L2 - https://www.tandfonline.com/doi/full/10.3109/02770903.2012.754028 DB - PRIME DP - Unbound Medicine ER -