Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study

• Published in: Advances in therapy 2020-06, Vol.37 (6), p.2916-2931
• Main Authors: Parimi, Mounika, Svedsater, Henrik, Ann, Quratul, Gokhale, Mugdha, Gray, Christen M., Hinds, David, Nixon, Mark, Boxall, Naomi
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Adolescent; Adult; Aged; Aged, 80 and over; Androstadienes - therapeutic use; Anti-Asthmatic Agents - therapeutic use; Asthma - drug therapy; Asthma - epidemiology; Beclomethasone - therapeutic use; Benzyl Alcohols - therapeutic use; Budesonide, Formoterol Fumarate Drug Combination - therapeutic use; Cardiology; Child; Chlorobenzenes - therapeutic use; Cohort Studies; Endocrinology; Female; Health technology assessment; Humans; Internal Medicine; Male; Medication Adherence - statistics & numerical data; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Research; Pharmacology/Toxicology; Retrospective Studies; Rheumatology; United Kingdom - epidemiology; Young Adult
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/s12325-020-01344-8

Introduction Asthma is associated with significant economic burden. Inhaled corticosteroid and long-acting beta 2 -agonist (ICS/LABA) combination therapies are considered mainstays of treatment. We describe real-world use of ICS/LABAs by comparing treatment persistence and adherence among patients with asthma in the United Kingdom initiating fluticasone furoate/vilanterol (FF/VI) versus budesonide/formoterol (BUD/FM) or beclometasone dipropionate/formoterol (BDP/FM). Methods A retrospective new-user active comparator database study was conducted in the IQVIA Medical Research Database. Propensity score (PS) matching was performed for FF/VI versus BUD/FM, and FF/VI versus BDP/FM. The primary objective was to compare patient treatment persistence (time to discontinuation), while secondary objectives included assessing adherence (mean proportion of days covered [PDC] with medication in the study period) and the proportions of patients achieving ≥ 50% and ≥ 80% PDC. Results New users of FF/VI ( N  = 966), BUD/FM ( N  = 5931) and BDP/FM ( N  = 9607) were identified and PS-matched: FF/VI ( n  = 945) versus BUD/FM ( n  = 3272), and FF/VI ( n  = 902) versus BDP/FM ( n  = 3465). At 12 months, treatment persistence was 69% (FF/VI), 53% (BUD/FM) and 57% (BDP/FM). The likelihood of treatment discontinuation within 12 months after initiation with FF/VI was 35% lower than with BUD/FM and 31% lower than for BDP/FM (both p