| アブストラクト | INTRODUCTION: Global Initiative for Asthma (GINA) recommends medium- or high-dose inhaled corticosteroid-long-acting beta2-agonist (ICS-LABA) as preferred treatments for patients with moderate-to-severe asthma. Limited data is available on how step 4/5 patients respond to ICS-LABA and how they step up/down in clinical practice. METHODS: This retrospective cohort study assessed the characteristics, control status, treatment pathways, and healthcare resource utilization in patients with asthma during one year after initiating medium- or high-dose ICS-LABA. Data from the United Kingdom Clinical Practice Research Datalink were analysed between January 01, 2006 and February 28, 2016. RESULTS: Overall, 29,229 and 16,575 patients initiated medium- and high-dose ICS-LABA, and 35.1% and 45.7% of patients, respectively, remained uncontrolled. The proportions of patients who were adherent to treatment (Medication Possession Ratio >/=80%) were 37.8% and 49.1% in the medium- and high-dose ICS-LABA cohorts, respectively. Among these adherent patients, 63.8% in the medium- and 70% in the high-dose cohorts remained uncontrolled. In patients who stepped up therapy in the medium-dose cohort (19.0%), the common step-up choices were add-on leukotriene receptor antagonist (LTRA) (42.2%), long-acting muscarinic antagonist (LAMA) (23.3%), and increase in ICS dose (22.9%). In patients who stepped up therapy in the high-dose cohort (26.1%), the common step-up choices were add-on LAMA (43.8%) and LTRA (42.1%). Healthcare resource utilization was higher in uncontrolled patients, regardless of the ICS-LABA dose. CONCLUSIONS: Many patients remain uncontrolled on both medium- or high-dose ICS-LABA, highlighting the need for timely assessment of asthma control to increase treatment intensity, following evidence-based treatment pathways. |
|---|
| ジャーナル名 | Respiratory medicine |
|---|
| 投稿日 | 2020/1/10 |
|---|
| 投稿者 | Buhl, Roland; Heaney, Liam G; Loefroth, Emil; Larbig, Michael; Kostikas, Konstantinos; Conti, Valentino; Cao, Hui |
|---|
| 組織名 | Pulmonary Department, Mainz University Hospital, Mainz, Germany. Electronic;address: Roland.Buhl@unimedizin-mainz.de.;Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical;Sciences, Queen's University Belfast, Belfast, United Kingdom.;Novartis Sverige AB, Kista, Sweden.;Novartis Pharma AG, Basel, Switzerland.;Respiratory Medicine Department, University of Ioannina Medical School, Ioannina,;Greece.;Novartis Ireland Limited, Dublin, Ireland.;Novartis Pharmaceuticals Corporation, East Hanover, NJ, United States. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31916534/ |
|---|
