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Comparative effectiveness of budesonide-formoterol combination and fluticasone-salmeterol combination for asthma management: a United States retrospective database analysis.
J Allergy Clin Immunol Pract. 2014 Nov-Dec; 2(6):719-26.JA

Abstract

BACKGROUND

Comparative effectiveness of the budesonide-formoterol fumarate dihydrate combination (BFC) and the fluticasone propionate-salmeterol combination (FSC) therapy on asthma exacerbation has not been assessed in real-world settings in the United States.

OBJECTIVE

To compare exacerbation rates and health care utilization for patients with asthma who initiate BFC versus FSC therapy.

METHODS

This retrospective cohort comparative effectiveness study queried medical and pharmacy data for patients with asthma from a large managed care data repository that covers major US population centers. The patients were 12 to 64 years old, with ≥12 months of pre- and postindex enrollment and ≥1 pharmacy claim(s) for BFC or FSC initiated during June 1, 2007, and September 30, 2010; the first prescription fill date was defined as the index date. Patients with other respiratory diseases and/or cancer were excluded. Exacerbation was defined as asthma-related hospitalization, emergency department visit, and/or oral corticosteroid prescription fill. Cohorts were matched by using propensity scores.

RESULTS

A total of 3043 patients per cohort were matched and balanced. During the 12 months following the initiation the BFC cohort had lower adjusted exacerbations per person year versus the FSC cohort (0.85 vs 0.93; RR 0.92, 95% CI [0.85-0.99]), lower oral corticosteroid fill rates, and fewer asthma-related emergency department visits but comparable asthma-related hospitalization.

CONCLUSIONS

Asthma exacerbation was lower for BFC versus FSC initiators due to lower rates of oral corticosteroid use and asthma-related emergency department visits, which indicate better treatment effectiveness of those patients initiated with BFC compared with FSC.

Authors+Show Affiliations

HealthCore Inc, Wilmington, Del. Electronic address: otunceli@healthcore.com.Astra Zeneca LP, Gaithersburg, Md.HealthCore Inc, Wilmington, Del.Astra Zeneca LP, Gaithersburg, Md.Astra Zeneca LP, Gaithersburg, Md.Astra Zeneca LP, Molndal, Sweden.HealthCore Inc, Wilmington, Del.Astra Zeneca LP, Wilmington, Del.

Pub Type(s)

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

Language

eng

PubMed ID

25439363

Citation

Tunceli, Ozgur, et al. "Comparative Effectiveness of Budesonide-formoterol Combination and Fluticasone-salmeterol Combination for Asthma Management: a United States Retrospective Database Analysis." The Journal of Allergy and Clinical Immunology. in Practice, vol. 2, no. 6, 2014, pp. 719-26.
Tunceli O, Williams SA, Kern DM, et al. Comparative effectiveness of budesonide-formoterol combination and fluticasone-salmeterol combination for asthma management: a United States retrospective database analysis. J Allergy Clin Immunol Pract. 2014;2(6):719-26.
Tunceli, O., Williams, S. A., Kern, D. M., Elhefni, H., Pethick, N., Wessman, C., Zhou, S., & Trudo, F. (2014). Comparative effectiveness of budesonide-formoterol combination and fluticasone-salmeterol combination for asthma management: a United States retrospective database analysis. The Journal of Allergy and Clinical Immunology. in Practice, 2(6), 719-26. https://doi.org/10.1016/j.jaip.2014.07.016
Tunceli O, et al. Comparative Effectiveness of Budesonide-formoterol Combination and Fluticasone-salmeterol Combination for Asthma Management: a United States Retrospective Database Analysis. J Allergy Clin Immunol Pract. 2014 Nov-Dec;2(6):719-26. PubMed PMID: 25439363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative effectiveness of budesonide-formoterol combination and fluticasone-salmeterol combination for asthma management: a United States retrospective database analysis. AU - Tunceli,Ozgur, AU - Williams,Setareh A, AU - Kern,David M, AU - Elhefni,Hanaa, AU - Pethick,Ned, AU - Wessman,Catrin, AU - Zhou,Siting, AU - Trudo,Frank, Y1 - 2014/10/03/ PY - 2013/08/23/received PY - 2014/06/17/revised PY - 2014/07/21/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/10/16/medline KW - Asthma KW - Budesonide-formoterol combination KW - Comparative effectiveness KW - Fluticasone-salmeterol combination KW - Inhaled corticosteroids KW - Long-acting β(2)-adrenergic agonist KW - Retrospective cohort study KW - short-acting β(2)-adrenergic-agonists SP - 719 EP - 26 JF - The journal of allergy and clinical immunology. In practice JO - J Allergy Clin Immunol Pract VL - 2 IS - 6 N2 - BACKGROUND: Comparative effectiveness of the budesonide-formoterol fumarate dihydrate combination (BFC) and the fluticasone propionate-salmeterol combination (FSC) therapy on asthma exacerbation has not been assessed in real-world settings in the United States. OBJECTIVE: To compare exacerbation rates and health care utilization for patients with asthma who initiate BFC versus FSC therapy. METHODS: This retrospective cohort comparative effectiveness study queried medical and pharmacy data for patients with asthma from a large managed care data repository that covers major US population centers. The patients were 12 to 64 years old, with ≥12 months of pre- and postindex enrollment and ≥1 pharmacy claim(s) for BFC or FSC initiated during June 1, 2007, and September 30, 2010; the first prescription fill date was defined as the index date. Patients with other respiratory diseases and/or cancer were excluded. Exacerbation was defined as asthma-related hospitalization, emergency department visit, and/or oral corticosteroid prescription fill. Cohorts were matched by using propensity scores. RESULTS: A total of 3043 patients per cohort were matched and balanced. During the 12 months following the initiation the BFC cohort had lower adjusted exacerbations per person year versus the FSC cohort (0.85 vs 0.93; RR 0.92, 95% CI [0.85-0.99]), lower oral corticosteroid fill rates, and fewer asthma-related emergency department visits but comparable asthma-related hospitalization. CONCLUSIONS: Asthma exacerbation was lower for BFC versus FSC initiators due to lower rates of oral corticosteroid use and asthma-related emergency department visits, which indicate better treatment effectiveness of those patients initiated with BFC compared with FSC. SN - 2213-2201 UR - https://www.unboundmedicine.com/medline/citation/25439363/Comparative_effectiveness_of_budesonide_formoterol_combination_and_fluticasone_salmeterol_combination_for_asthma_management:_a_United_States_retrospective_database_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-2198(14)00338-9 DB - PRIME DP - Unbound Medicine ER -