Stepping down from high dose fluticasone/salmeterol to extrafine BDP/F in asthma is cost-effective

Paggiaro, Pierluigi; Patel, Shishir; Nicolini, Gabriele; Pradelli, Lorenzo; Zaniolo, Orietta; Papi, Alberto

doi:10.1016/j.rmed.2013.07.010

Cited by 16 publications

(16 citation statements)

References 22 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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“…Altogether, 46 relevant articles were identified: n = 24 for PICOT question 1 [7, 29, 35, 36, 38, 42–59 ], 7 for PICOT question 2 [34, 39, 60–64 ], 3 for PICOT question 3 [33, 65, 66 ] and 12 for PICOT question 4 [32, 40, 67–76 ]. Figure 4 shows the results of the quality assessment of all papers by PICOT question and Fig.…”

Section: Resultsmentioning

confidence: 99%

Quality standards in respiratory real-life effectiveness research: the REal Life EVidence AssessmeNt Tool (RELEVANT): report from the Respiratory Effectiveness Group—European Academy of Allergy and Clinical Immunology Task Force

Roche

Campbell

Krishnan

et al. 2019

Clin Transl Allergy

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Introduction A Task Force was commissioned jointly by the European Academy of Allergy and Clinical Immunology (EAACI) and the Respiratory Effectiveness Group (REG) to develop a quality assessment tool for real-life observational research to identify high-quality real-life asthma studies that could be considered within future guideline development. Methods The resulting REal Life EVidence AssessmeNt Tool (RELEVANT) was achieved through an extensive analysis of existing initiatives in this area. The first version was piloted among 9 raters across 6 articles; the revised, interim, version underwent extensive testing by 22 reviewers from the EAACI membership and REG collaborator group, leading to further revisions and tool finalisation. RELEVANT was validated through an analysis of real-life effectiveness studies identified via systematic review of Medline and Embase databases and relating to topics for which real-life studies may offer valuable evidence complementary to that from randomised controlled trials. The topics were selected through a vote among Task Force members and related to the influence of adherence, smoking, inhaler device and particle size on asthma treatment effectiveness. Results Although highlighting a general lack of high-quality real-life effectiveness observational research on these clinically important topics, the analysis provided insights into how identified observational studies might inform asthma guidelines developers and clinicians. Overall, RELEVANT appeared reliable and easy to use by expert reviewers. Conclusions Using such quality appraisal tools is mandatory to assess whether specific observational real-life effectiveness studies can be used to inform guideline development and/or decision-making in clinical practice. Electronic supplementary material The online version of this article (10.1186/s13601-019-0255-x) contains supplementary material, which is available to authorized users.

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“…Studies originated from different countries and jurisdictions: 17 studies were from the United States, 4,7,11-25 5 were from Canada, [26][27][28][29][30] 6 were from the UK, 31-36 9 were from other European countries, 6,37-44 4 were from South America, and [45][46][47][48] 3 were from South East Asia and Australia [49][50][51] ; 1 study involved multiple countries. 52 In 8 studies, the target population was exclusively pediatric patients 12,13,17,28,41,[46][47][48] ; the remaining were in adults or the combination of adults, adolescents, and children.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Thirty studies evaluated pharmacological therapies in asthma. 4,6,7,[11][12][13][14]16,18,19,[21][22][23][24]26,27,29,[31][32][33]35,36,39,40,[45][46][47][48]50,52 Among these, 12 considered at least 1 of the recently introduced biologics. 16,19,[21][22][23]27,32,33,39,40,45,50 Bronchial thermoplasty was assessed in 4 studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

A Systematic Review of Decision-Analytic Models for Evaluating Cost-Effectiveness of Asthma Interventions

et al. 2019

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To demonstrate the landscape of model-based economic studies in asthma and highlight where there is room for improvement in the design and reporting of studies.Design: A systematic review of the methodologies of model-based, cost-effectiveness analyses of asthma-related interventions was conducted. Models were evaluated for adherence to best-practice modeling and reporting guidelines and assumptions about the natural history of asthma.Methods: A systematic search of English articles was performed in MEDLINE, EMBASE, and citations within reviewed articles. Studies were summarized and evaluated based on their adherence to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). We also studied the underlying assumptions about disease progression, heterogeneity in disease course, comorbidity, and treatment effects.Results: Forty-five models of asthma were included (33 Markov models, 10 decision trees, 2 closed-form equations). Novel biological treatments were evaluated in 12 studies. Some of the CHEERS' reporting recommendations were not satisfied, especially for models published in clinical journals. This was particularly the case for the choice of the modeling framework and reporting on heterogeneity. Only 13 studies considered any subgroups, and 2 explicitly considered the impact of comorbidities. Adherence to CHEERS requirements and the quality of models generally improved over time. Conclusion:It would be difficult to replicate the findings of contemporary model-based evaluations of asthma-related interventions given that only a minority of studies reported the essential parameters of their studies. Current asthma models generally lack consideration of disease heterogeneity and do not seem to be ready for evaluation of precision medicine technologies.

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Stepping down from high dose fluticasone/salmeterol to extrafine BDP/F in asthma is cost-effective

Cited by 16 publications

References 22 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

Quality standards in respiratory real-life effectiveness research: the REal Life EVidence AssessmeNt Tool (RELEVANT): report from the Respiratory Effectiveness Group—European Academy of Allergy and Clinical Immunology Task Force

A Systematic Review of Decision-Analytic Models for Evaluating Cost-Effectiveness of Asthma Interventions

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