US Value, Evidence and Outcomes, GlaxoSmithKline plc., NC, USA.
Health Economics and Outcomes Research, Groupe d'analyses, Ltée, Montréal, QC, Canada.
J Asthma. 2022 Sep;59(9):1805-1818. doi: 10.1080/02770903.2021.1963767. Epub 2021 Aug 25.
Treatment with fluticasone furoate/vilanterol (FF/VI), an inhaled corticosteroid/long-acting β-agonist therapy, reduces the risk of severe asthma exacerbations and improves lung function and symptom control in patients with asthma. However, real-world data remain limited among asthma patients in the United States (US).
This retrospective cohort study propensity score (PS) matched adult asthma patients initiating once-daily FF/VI 100/25 mcg with patients initiating twice-daily budesonide/formoterol (B/F) 160/4.5 mcg using a US claims database (January 1, 2015-December 31, 2018). Asthma control was measured by the mean number of short-acting β-agonist (SABA) canisters dispensed per patient-year (PPY) during follow-up. Time to first, and rates of, overall and severe asthma exacerbations were also measured.
After PS matching, 18,531 patients receiving FF/VI were matched to 18,531 patients receiving B/F. Mean SABA canisters dispensed PPY was significantly lower for FF/VI users compared with B/F users (FF/VI: 1.47, B/F: 1.64; < 0.001). FF/VI use resulted in 13% significantly lower risk of having an overall asthma-related exacerbation and 22% lower risk of a severe exacerbation versus B/F use (overall exacerbation hazard ratio [HR] [95% confidence interval (CI)]: 0.87 [0.82-0.92], < 0.001; severe exacerbation HR [95% CI]: 0.78 [0.63-0.97], = 0.027). Asthma-related exacerbation rates per 100 patient-days were also significantly lower for the FF/VI group compared with the B/F group (overall: 0.0475 vs. 0.0558, < 0.001; severe: 0.0026 vs. 0.0033, = 0.020).
In real-world practice, initiation of once-daily FF/VI 100/25 mcg in adults with asthma was associated with lower use of SABA and fewer asthma-related exacerbations, which may indicate better asthma control, when compared with use of twice-daily B/F 160/4.5 mcg.
氟替卡松维兰特罗（FF/VI）是一种吸入性皮质类固醇/长效β激动剂疗法，治疗可降低哮喘患者严重哮喘加重的风险，并改善肺功能和症状控制。然而，美国（US）哮喘患者的真实世界数据仍然有限。
本回顾性队列研究使用美国索赔数据库（2015 年 1 月 1 日至 2018 年 12 月 31 日），对每日一次 FF/VI 100/25mcg 起始治疗的成年哮喘患者进行倾向评分（PS）匹配，以匹配每日两次布地奈德/福莫特罗（B/F）160/4.5mcg 起始治疗的患者。通过随访期间每位患者每年（PPY）使用的短效β激动剂（SABA）罐数来衡量哮喘控制情况。还测量了首次发生和总体及重度哮喘加重的时间和发生率。
PS 匹配后，18531 例接受 FF/VI 治疗的患者与 18531 例接受 B/F 治疗的患者相匹配。与 B/F 组相比，FF/VI 组患者的 SABA 罐 PPY 明显更低（FF/VI：1.47，B/F：1.64；<0.001）。与 B/F 相比，FF/VI 治疗可使总体哮喘相关加重的风险降低 13%，严重加重的风险降低 22%（总体加重风险比[HR] [95%置信区间（CI）]：0.87 [0.82-0.92]，<0.001；严重加重 HR [95% CI]：0.78 [0.63-0.97]，=0.027）。与 B/F 组相比，FF/VI 组的哮喘相关加重率也明显更低（每 100 患者日：总体：0.0475 比 0.0558，<0.001；严重：0.0026 比 0.0033，=0.020）。
在真实世界的实践中，与每日两次 B/F 160/4.5mcg 相比，成人哮喘患者每日一次 FF/VI 100/25mcg 的起始治疗与更低的 SABA 使用量和更少的哮喘相关加重相关，这可能表明更好的哮喘控制。
