Eympres Research, LLC, Hilliard, OH 43026, USA.
Value Health. 2011 Mar-Apr;14(2):339-46. doi: 10.1016/j.jval.2011.01.001.
Differences between mometasone furoate (MF), administered once daily, and fluticasone propionate (FP), administered twice daily, dosing regimens may affect adherence and short-acting β(2) agonist (SABA) use. The objective of this analysis was to compare asthma control outcomes in matched cohorts of MF- and FP-treated asthma patients stratified by SABA claims.
A retrospective pharmacy claims database analysis identified matched cohorts of asthma patients (aged 12-65 years) who initiated treatment with MF or FP. Patients with none, one to four, five to eight, or more than eight SABA preindex claims were stratified to categories A, B, C, and D, respectively. Bivariate analyses compared postindex SABA canister claims, adherence, and exacerbations; multivariate analyses compared postindex SABA canister claims.
Matched patients in categories A (n = 2517 per cohort) and B (n = 2329 per cohort) were analyzed; insufficient sample sizes were identified for categories C and D. Postindex bivariate analyses indicated that MF cohorts had fewer SABA claims compared to FP cohorts (category A, 0.80 vs. 1.17 [P < 0.0001]; category B, 1.39 vs. 1.58 [P < 0.0001]), better adherence to the index drug (category A, 24% vs. 15% [P < 0.0001]; category B, 27% vs. 15% [P < 0.0001]), and fewer exacerbations (category A, 0.17 vs. 0.19 [P = 0.011]; category B, 0.17 vs. 0.21 [P = 0.008]). Multivariate analyses indicated that MF cohorts had fewer postindex SABA claims compared to FP cohorts in categories A and B (P < 0.0001).
Data for SABA claims, treatment adherence, and exacerbations suggest that, compared to twice-daily FP, once-daily MF may provide better asthma control.
倍氯米松糠酸酯(MF)每日 1 次给药与丙酸氟替卡松(FP)每日 2 次给药,两种给药方案的差异可能会影响用药依从性和短效β2 受体激动剂(SABA)的使用。本分析的目的是比较 SABA 用药情况分层的 MF 和 FP 治疗哮喘患者匹配队列的哮喘控制结局。
回顾性药物使用数据库分析确定了起始接受 MF 或 FP 治疗的哮喘患者匹配队列(年龄 12-65 岁)。无、1-4、5-8、8 次以上 SABA 预索引用药索赔的患者分别分层至 A、B、C 和 D 类。双变量分析比较了 SABA 药罐用药、用药依从性和哮喘加重情况;多变量分析比较了 SABA 药罐用药情况。
分析了 A 类(每队列 2517 例患者)和 B 类(每队列 2329 例患者)的匹配患者;C 类和 D 类的样本量不足。SABA 药罐用药的双变量分析显示,MF 队列的 SABA 用药比 FP 队列少(A 类 0.80 比 1.17[P<0.0001];B 类 1.39 比 1.58[P<0.0001]),对指数药物的用药依从性更好(A 类 24%比 15%[P<0.0001];B 类 27%比 15%[P<0.0001]),哮喘加重更少(A 类 0.17 比 0.19[P=0.011];B 类 0.17 比 0.21[P=0.008])。多变量分析表明,A 类和 B 类 MF 队列的 SABA 用药比 FP 队列少(P<0.0001)。
SABA 用药、治疗依从性和哮喘加重的数据表明,与每日 2 次 FP 相比,每日 1 次 MF 可能提供更好的哮喘控制。