Clinical and cost effectiveness of switching asthma patients from fluticasone-salmeterol to extra-fine particle beclometasone-formoterol: a retrospective matched observational study of real-world patients

Price, David; Small, Iain; Haughney, John; Ryan, Dermot; Gruffydd-Jones, Kevin; Lavorini, Federico; Harris, Tim A. J.; Burden, Annie; Brockman, J; King, Christine; Papi, Alberto

doi:10.4104/pcrj.2013.00088

Cited by 41 publications

(28 citation statements)

References 41 publications

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“…The results obtained showed that patients treated with the combination budesonide/formoterol, both as maintenance therapy that as emergency therapy, showed a lower number of asthma exacerbations, fewer hospitalizations and a reduction in the use of oral steroids compared patients treated with SABA as needed. Similar results were found in at least three other works [21][22][23], in which recourse to the ixed combinations budesonide/formoterol showed ef icacy not only as maintenance therapy, but also as a drug to be used as needed, improving control symptoms and lung function.…”

Section: Discussionsupporting

confidence: 86%

Fluticasone furoate/Vilanterol 92/22 μg once-a-day vs Beclomethasone dipropionate/Formoterol 100/6 μg b.i.d. in asthma patients: a 12-week pilot study

Terzano¹,

Oriolo²

2017

J Pulmonol Respir Res

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Two of the most recent LABA/ICS combinations for treatment of persistent asthma are Fluticasone furoate/ Vilanterol 92/22 μg (Ellipta) and Beclomethasone dipropionate/Formoterol 100/6 μg (Nexthaler). Objective:To compare once-daily Fluticasone/ Vilanterol combination with twice daily Beclomethasone/ Formoterol association in moderate asthma, in terms of quality of life and lung function.Methods: Fourty patients with moderate asthma treated with Beclomethasone/Formoterol 100/6 μg or Fluticasone/Vilanterol 92/22 μg. We revalued patients in terms of lung function and Asthma Control Test, at 4, 8 and 12 weeks to assess any differences between the two groups. After 4 weeks, thirty-one of the fourty patients were evaluated in terms of respiratory function at predetermined time intervals.Result: In patients treated with beclomethasone/formoterol FEV1 presented a mean value of 78% at the third visit and of 79.1% during the fi nal check, compared with 74.5% and to 75.8% in patients in treatment with fl uticasone/vilanterol (p 0.01). Mean values of IC and MMEF25-75% were higher in patients treated with beclomethasone/formoterol compared with fl uticasone/vilanterol. For the dyspnea it was a difference at the third observation. For the nocturnal symptoms and the use of rescue drug there was a signifi cant difference, except at the beginning. For the perception of control by patients, there was a difference in the two groups at the beginning, after 4 and 8 weeks. Total ACT score showed a signifi cant difference after 4, 8 and 12 weeks. In the group treated with beclomethasone/formoterol FEV1 value was signifi cantly higher at a distance of four hours after drug administration (p 0.04) and after the second dose (p 0.02) compared with the group treated with fl uticasone/vilanterol. Discussion: Patients in treatment with beclomethasone/formoterol showed improved asthma control and nocturnal symptoms and more stable respiratory function compared with patients receiving fl uticasone/ vilanterol.

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Section: Discussionsupporting

confidence: 86%

Fluticasone furoate/Vilanterol 92/22 μg once-a-day vs Beclomethasone dipropionate/Formoterol 100/6 μg b.i.d. in asthma patients: a 12-week pilot study

Terzano¹,

Oriolo²

2017

J Pulmonol Respir Res

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“…In a retrospective, matched, observational study of patients with asthma who either continued the existing therapy with fluticasone propionate/salmeterol (n = 1,146) or were switched to an extra-fine formulation of beclometasone dipropionate/formoterol (n = 382) following either a face-to-face or an electronic review, there was no difference in the number of severe exacerbations reported, with ~80% of each treatment group reporting no exacerbations and ~6.4% reporting 2 or more [26]. However, in cases in which a device is switched without discussion with the patient (i.e.…”

Section: Implications Of Switching Devicesmentioning

confidence: 99%

The Importance of Continuity in Inhaler Device Choice for Asthma and Chronic Obstructive Pulmonary Disease

Bjermer

2014

Respiration

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Inhaled therapies are central to the treatment of asthma and chronic obstructive pulmonary disease. Physicians consider many factors when selecting the most appropriate inhaler device, including device efficacy and the cost to the health care system. This review aims to discuss the factors that are important when considering inhaler devices and the importance of continuity in the choice of inhaler device.A large number of factors can contribute to therapeutic outcomes with inhalation devices. The inhalation technique is critical to treatment success and differs substantially between inhaler devices. Misuse of an inhaler is common, and thorough training of patients and physicians is important to ensure correct utilization. Patient satisfaction is an important consideration because it is significantly correlated with compliance and better outcomes. Financial pressures contribute to decision making: although selecting the less expensive inhaler device might reduce direct treatment costs, it can have a large impact on disease control and the patient's well-being. Switching may be associated with a poor inhalation technique, reduced disease control and quality of life, increased use of other treatments and health care resources, and a greater chance of unsuccessful treatment. Nonconsensual switches can result in patient discontent, reduced confidence in the medication, and uncertainty regarding the degree of disease control. It is recommended that patients with stable disease remain on their current device. If a switch is considered, the patient should be consulted and the physician should take into account the patient's preference, their ability to correctly use the device, and the availability of the preferred drug in the preferred device.

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“…The direct cost of COPD in the US was estimated as 29.5 billion USD, with an additional estimated indirect cost of 20.4 billion USD [16]. Although, previous studies have investigated strategies to achieve the cost effective treatment of asthma [17], there are few pharmacoeconomic studies investigating the cost of drugs [18].…”

Section: Discussionmentioning

confidence: 99%

Are treatment guides and rational drug use policies adequately exploited in combating respiratory system diseases?

Doğan¹,

Mutlu²,

Yılmaz³

et al. 2016

Journal of Infection and Public Health

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The aim of the present study was to increase awareness regarding the rational use of medicines. The data were obtained via the Material Resources Management System Module of the Ministry of Health. For the appropriateness of treatments, the Global Initiative for Asthma, the Global Initiative for Chronic Obstructive Lung Disease, and the guidelines for the rational use of medicines were used. We also investigated whether any de-escalation method or physical exercise was performed. Statistical analyses were performed using descriptive statistics to determine the mean, standard deviation, and frequency. The results showed that healthcare providers ignored potential drug reactions or adverse interactions, and reflecting the lack of adherence to the current treatment guides, 35.8% irrational use of medicines was recorded. Thus, de-escalation methods should be used to decrease costs or narrow the antibiotic spectrum, antibiotic selection should consider the resistance patterns, culturing methods should be analyzed, and monotherapy should be preferred over combination treatments.

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Clinical and cost effectiveness of switching asthma patients from fluticasone-salmeterol to extra-fine particle beclometasone-formoterol: a retrospective matched observational study of real-world patients

Cited by 41 publications

References 41 publications

Fluticasone furoate/Vilanterol 92/22 μg once-a-day vs Beclomethasone dipropionate/Formoterol 100/6 μg b.i.d. in asthma patients: a 12-week pilot study

Fluticasone furoate/Vilanterol 92/22 μg once-a-day vs Beclomethasone dipropionate/Formoterol 100/6 μg b.i.d. in asthma patients: a 12-week pilot study

The Importance of Continuity in Inhaler Device Choice for Asthma and Chronic Obstructive Pulmonary Disease

Are treatment guides and rational drug use policies adequately exploited in combating respiratory system diseases?

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