Newer fixed-dose ICS/LABA combos tied to greater adherence, less exacerbations in asthma

Among fixed-dose combinations of inhaled corticosteroids/long-acting beta-2-adrenergic agonists (ICS/LABA), the newer combinations of fluticasone furoate/vilanterol (FF/VI) and fluticasone propionate/formoterol (FP/FORM) are associated with increased treatment persistence and lead to fewer exacerbations among patients with asthma, as shown in a study.

Researchers reviewed the medical records of 3,203 adult patients who were initiating inhaler treatment with combinations of ICS/LABA for the treatment of asthma in routine clinical practice. The mean age of the population was 52.2 years, with 60.8 percent of patients being women and 44.9 percent having moderate persistent asthma. All patients were followed for 1 year.

In terms of the initial fixed-dose combination of ICS/LABA used, 31.1 percent of patients initiated fluticasone propionate/salmeterol (FP/SAL), 28.6 percent beclomethasone/formoterol (BDP/FORM), 25.0 percent budesonide/formoterol (BDP/FORM), 8.2 percent FF/VI, and 7.0 percent FP/FORM.

Treatment persistence over 1 year was 61.7 percent (95 percent confidence interval [CI], 60.0–63.4). Persistence was higher with FP/FORM (67.6 percent) and FF/VI (66.7 percent) than with FP/SAL (60.7 percent), BDP/FORM (61.2 percent), and BUD/FORM (60.3 percent; p=0.046).

The same was true for medication possession ratio (MPR), which was higher with FP/FORM (80.6 percent) and FF/VI (79.4 percent) vs FP/SAL (74.3 percent), BDP/FORM (73.8 percent), and BUD/FORM (74.6 percent; p=0.028).

Overall, 21.5 percent of patients experienced some form of exacerbation, with slightly lower rates in groups treated with FP/FORM and FF/VI.

The proportion of patients who had exacerbations according to treatment was as follows: 16.0 percent (95 percent CI, 12.2–19.3) with FP/FORM, 17.9 percent (95 percent CI, 14.9–20.7) with FF/VI, 21.9 percent (95 percent CI, 19.3–24.5) with FP/SAL, 22.2 percent (95 percent CI, 19.5–24.9) with BDP/FORM, and 22.8 percent (95 percent CI, 19.9–25.7) with BUD/FORM (p=0.036).

Further studies will be needed to validate the results.