Outcomes and costs of patients with persistent asthma treated with beclomethasone dipropionate hydrofluoroalkane or fluticasone propionate

Lage, Maureen J.; Gross, Gary N.; Brewster, C.; Spalitto, Anthony

doi:10.1007/s12325-009-0056-z

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…A number of observational studies and historical matched cohort analyses have recently been published comparing the outcomes and cost of treatment with small versus standard size particle ICS in patients with asthma [ 43 – 46 ]. In general, the studies found that asthma treatment outcomes were similar or better with small size particle ICS (BDP) compared with standard size particle ICS (FP).…”

Section: Discussionmentioning

confidence: 99%

Effect of inhaled corticosteroid particle size on asthma efficacy and safety outcomes: a systematic literature review and meta-analysis

Baou

Alfonso-Cristancho

et al. 2017

BMC Pulm Med

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BackgroundInhaled corticosteroids (ICS) are the primary treatment for persistent asthma. Currently available ICS have differing particle size due to both formulation and propellant, and it has been postulated that this may impact patient outcomes. This structured literature review and meta-analysis compared the effect of small and standard particle size ICS on lung function, symptoms, rescue use (when available) and safety in patients with asthma as assessed in head-to-head randomized controlled trials (RCTs).MethodsA systematic literature search of MEDLINE was performed to identify RCTs (1998–2014) evaluating standard size (fluticasone propionate-containing medications) versus small particle size ICS medication in adults and children with asthma. Efficacy outcomes included forced expiratory volume in 1 s (FEV1), morning peak expiratory flow (PEF), symptom scores, % predicted forced expiratory flow between 25 and 75% of forced vital capacity (FEF25–75%), and rescue medication use. Safety outcomes were also evaluated when available.ResultsTwenty-three independent trials that met the eligibility criteria were identified. Benefit-risk plots did not demonstrate any clinically meaningful differences across the five efficacy endpoints considered and no appreciable differences were noted for most safety endpoints. Meta-analysis results, using a random-effects model, demonstrated no significant difference between standard and small size particle ICS medications in terms of effects on mean change from baseline FEV1 (L) (−0.011, 95% confidence interval [CI]: −0.037, 0.014 [N = 3524]), morning PEF (L/min) (medium/low doses: −3.874, 95% CI: −10.915, 3.166 [N = 1911]; high/high-medium doses: 5.551, 95% CI: −1.948, 13.049 [N = 749]) and FEF25–75% predicted (−2.418, 95% CI: −6.400; 1.564 [N = 115]).ConclusionsBased on the available literature, no clinically significant differences in efficacy or safety were observed comparing small and standard particle size ICS medications for the treatment of asthma.Trial registrationGSK Clinical Study Register No: 202012.

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Section: Discussionmentioning

confidence: 99%

Effect of inhaled corticosteroid particle size on asthma efficacy and safety outcomes: a systematic literature review and meta-analysis

Baou

Alfonso-Cristancho

et al. 2017

BMC Pulm Med

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“… 32 More recently, in a 1-year US database study, significantly lower drug and total medical costs and fewer emergency department visits were reported with extrafine beclomethasone compared with fluticasone for adults and children (5–64 years old) with persistent asthma. 33 Prior studies comparing extrafine beclomethasone and fluticasone were short-term (3–12 weeks) randomised trials that did not evaluate cost-effectiveness. 34 …”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of initiating extrafine- or standard size-particle inhaled corticosteroid for asthma in two health-care systems: a retrospective matched cohort study

Martin

Price

Roche

et al. 2014

npj Prim Care Resp Med

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Background:Real-life studies are needed to determine the cost-effectiveness of asthma therapies in clinical practice.Aim:To compare the cost-effectiveness of extrafine-particle inhaled corticosteroid (ICS) with standard size-particle ICS in the United Kingdom (UK) and United States (US).Methods:These retrospective matched cohort analyses used large electronic databases to study asthma-related outcomes for patients in the UK (12–60 years old; n=1730) and US (12–80 years; n=10,312) prescribed extrafine beclomethasone or fluticasone as their first ICS therapy for asthma. Patients were matched on demographic characteristics and asthma severity during 1 baseline year, and asthma control and asthma-related costs were compared during 1 outcome year.Results:In both the UK and US, adjusted odds of risk-domain asthma control were similar, whereas the odds of overall control (no hospitalisation or oral steroids for asthma, no antibiotics for lower respiratory infection, limited reliever use) were greater for extrafine ICS in both countries (UK odds ratio, 1.23; 95% confidence interval (CI), 1.01–1.50). Asthma-related annual costs, adjusted for baseline, were significantly lower for extrafine-particle ICS cohorts in both countries (UK difference, −£66 (95% CI,−93 to −37)). Cost-effectiveness analyses using the two measures of asthma control found 92 and 98% probabilities of extrafine-particle ICS being the preferred treatment strategy (less costly and more effective than standard size-particle ICS) in the UK, and 84 and 100% probabilities in the US.Conclusions:Initiating ICS therapy for asthma as extrafine-particle ICS seems the dominant treatment option (less costly and more effective) compared with standard size-particle ICS in both the UK and the US.

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“…It has been shown that the current standard treatment of asthma with ICSs is not available in countries in which basic inhaled medications containing ICSs are not available to many patients because of their high cost [75,88]. At the same time, the cost of basic inhaled medications containing corticosteroids is still not decreasing [92][93][94][95]. At the same time, the incidence of asthma is increasing and the income of the population in many countries remains low [96].…”

Section: Resultsmentioning

confidence: 99%

Suffocation in asthma and COVID-19: Supplementation of inhaled corticosteroids with alkaline hydrogen peroxide as an alternative to ECMO

Urakov,

Urakova,

Shabanov

et al. 2023

Preprint

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Suffocation syndrome is the leading cause of hypoxia and mortality in the most common lung diseases, asthma and COVID-19. Inhaled corticosteroids (ICSs) have been shown to be the main-stay of critical care in these diseases. Meanwhile, mortality from strangulated hypoxia is highest in low-income countries because ICSs are not currently available to many patients. Warm alkaline hydrogen peroxide solutions (WAHPSs) have reportedly been invented in recent years to urgently turn thick sputum, mucus, pus, serous fluid, blood clots and many other biological masses con-taining the enzyme catalase into a fluffy oxygenated foam. It has been shown that the mechanism of action of WAHPSs consists in alkaline saponification of lipid and protein-lipid complexes of bi-ological masses and their transformation into oxygen foam, because hydrogen peroxide is urgently decomposed into water and oxygen gas under the action of the biological masses catalase enzyme At that excess oxygen is absorbed into blood through lungs and increases blood oxygen saturation. Based on the described mechanism of action of WAHPSs and the high availability of their ingre-dients, it is suggested that mortality from choking and hypoxia in asthma and COVID-19 can be reduced by combining ICSs with inhaled WAHPSs, especially in poor countries. The essence of the inventions underlying the formation of WAHPSs is given.

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Outcomes and costs of patients with persistent asthma treated with beclomethasone dipropionate hydrofluoroalkane or fluticasone propionate

Cited by 6 publications

References 38 publications

Effect of inhaled corticosteroid particle size on asthma efficacy and safety outcomes: a systematic literature review and meta-analysis

Effect of inhaled corticosteroid particle size on asthma efficacy and safety outcomes: a systematic literature review and meta-analysis

Cost-effectiveness of initiating extrafine- or standard size-particle inhaled corticosteroid for asthma in two health-care systems: a retrospective matched cohort study

Suffocation in asthma and COVID-19: Supplementation of inhaled corticosteroids with alkaline hydrogen peroxide as an alternative to ECMO

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