Averell Carlyne M, Laliberté François, Germain Guillaume, Slade David J, Duh Mei S, Spahn Joseph
GlaxoSmithKline plc., Research Triangle Park, NC, USA.
Groupe d'analyse, Ltée, Montréal, QC, Canada.
J Asthma. 2022 Aug;59(8):1687-1696. doi: 10.1080/02770903.2021.1955377. Epub 2021 Aug 4.
To assess asthma burden and medication adherence in a US de-identified patient level claims database.
This retrospective observational study used the IQVIA PHARMETRICS PLUS database to identify patients aged 5-17 years, diagnosed with asthma between 01/01/2012-09/30/2017 (asthma cohort), and those initiating treatment with twice-daily inhaled corticosteroids (ICS) or twice-daily ICS/long-acting beta agonists (LABA) (treatment cohorts; index date = first dispensing). Patient characteristics, asthma medication, and healthcare resource utilization were assessed over a 12-month baseline period. Treatment cohort endpoints were assessed in a 12-month follow-up period, including: adherence using proportion of days covered (PDC); persistence (no gap >45 days between dispensings).
The asthma cohort included 186,868 patients (112,689 children, mean age 7.9 years; 74,179 adolescents, mean age 14.3 years). During baseline, 34.5% used ICS or ICS/LABA, 24% used oral corticosteroids, 11.1% had ≥1 asthma-related emergency department visit, 2.2% had ≥1 asthma-related hospitalization. Among treatment cohorts, 47,276 and 10,247 patients initiated twice-daily ICS and ICS/LABA, respectively (mean ages: 9.9; 12.5 years). Mean PDC adherence to twice-daily ICS and ICS/LABA was 30% and 34% at 6 months (PDC ≥0.8: 4.3%; 6.1%); 21% and 24% at 12 months (PDC ≥0.8: 1.8%; 2.8%). Persistence with twice-daily ICS and ICS/LABA was 10.1% and 14.2% at 6 months; 5.6% and 8.0% at 12 months.
A large disease burden and unmet need exist among US children/adolescent asthma patients, evidenced by low use of, and poor adherence to, ICS-containing medication, the notable proportion of oral corticosteroid users, and higher-than-expected asthma-related emergency department and hospitalization rates.
在美国一个去除身份标识的患者层面索赔数据库中评估哮喘负担和药物依从性。
这项回顾性观察性研究使用IQVIA PHARMETRICS PLUS数据库来识别年龄在5至17岁之间、在2012年1月1日至2017年9月30日期间被诊断为哮喘的患者（哮喘队列），以及那些开始接受每日两次吸入性糖皮质激素（ICS）或每日两次ICS/长效β受体激动剂（LABA）治疗的患者（治疗队列；索引日期=首次配药）。在12个月的基线期内评估患者特征、哮喘药物和医疗资源利用情况。在12个月的随访期内评估治疗队列终点，包括：使用覆盖天数比例（PDC）评估依从性；持续性（两次配药之间无间隔>45天）。
哮喘队列包括186,868名患者（112,689名儿童，平均年龄7.9岁；74,179名青少年，平均年龄14.3岁）。在基线期，34.5%的患者使用ICS或ICS/LABA，24%的患者使用口服糖皮质激素，11.1%的患者有≥1次与哮喘相关的急诊科就诊，2.2%的患者有≥1次与哮喘相关的住院治疗。在治疗队列中，分别有47,276名和10,247名患者开始每日两次使用ICS和ICS/LABA（平均年龄：9.9岁；12.5岁）。每日两次使用ICS和ICS/LABA的平均PDC依从性在6个月时分别为30%和34%（PDC≥0.8：4.3%；6.1%）；在12个月时分别为21%和24%（PDC≥0.8：1.8%；2.8%）。每日两次使用ICS和ICS/LABA的持续性在6个月时分别为10.1%和14.2%；在12个月时分别为5.6%和8.0%。
美国儿童/青少年哮喘患者中存在巨大的疾病负担和未满足的需求，这表现为含ICS药物的使用和依从性差、口服糖皮质激素使用者比例显著、以及高于预期的与哮喘相关的急诊科就诊率和住院率。
