Comparison of multiple-inhaler and single-inhaler therapy for management of asthma

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Created On: 05/12/2023

To distinguish between the use of single-inhaler Fluticasone furoate/Umeclidinium/Vilanterol (FF 100 mcg/UMEC 62.5 mcg/VI 25 mcg) and multiple-inhaler triple therapy (MITT) in terms of adherence and persistence in adult asthma patients.

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Key take away

Single-inhaler triple therapy may offer significant benefits (higher adherence and treatment persistence) over multiple-inhaler triple therapy for managing asthma.

Background

Method

In this retrospective cohort study, IQVIA PharMetrics Plus data (a longitudinal health plan database) was used to assess the patients with asthma who had begun once-daily FF/UMEC/VI or MITT.

The differences in characteristics between the FF/UMEC/VI and MITT groups were addressed with the help of statistical analysis. Adherence was evaluated using two metrics: the proportion of days covered (PDC) and the percentage of patients attaining PDC values of 0.8 or higher and 0.5 or higher. Non-persistence was well-defined as a gap of more than 45 days amongst the prescription refills.

Result

The study encompassed 1396 individuals who initiated FF/UMEC/VI and 5115 who initiated MITT. Three months after starting their respective treatments, FF/UMEC/VI users proved to have notably higher mean PDC values than the MITT users (0.68 vs. 0.59; p < .001). Furthermore, FF/UMEC/VI users were 31% more likely to achieve adherence with a PDC of 0.8 or higher (adjusted risk ratio [95% confidence interval (CI)]: 1.31 [1.13-1.54]; Table 1). Similar trends were observed at 6 and 12 months following initiation.

Additionally, FF/UMEC/VI users exhibited a 49% higher likelihood of persisting with their treatment at the 12-month mark compared to MITT users (adjusted hazard ratio [95% CI]: 1.49 [1.39-1.60]; Table 2):

Conclusion

Patients with asthma who initiated triple therapy with FF/UMEC/VI displayed significantly improved adherence and persistence in comparison to those who initiated MITT.