CHEST Annual Meeting

CHEST Annual Meeting

Source:

Zhang WS, et al. Asthma Abstract Posters. Presented at: CHEST Annual Meeting; Oct. 17-20, 2021 (virtual meeting).

Disclosures: Zhang is an employee of GlaxoSmithKline.
October 25, 2021
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Discontinuation of multiple-inhaler triple therapy high among patients with asthma

Source:

Zhang WS, et al. Asthma Abstract Posters. Presented at: CHEST Annual Meeting; Oct. 17-20, 2021 (virtual meeting).

Disclosures: Zhang is an employee of GlaxoSmithKline.
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Among new initiators of multiple-inhaler triple therapy for asthma, discontinuation was high, although approximately one-third of patients reinitiated their therapy, researchers reported at the CHEST Annual Meeting.

“There is a limited amount of real-world data on treatment patterns after the discontinuation of therapy in the U.S.,” William Shiyuan Zhang, value evidence and outcomes director at GlaxoSmithKline, said during a presentation.

Asthma child
Source: Adobe Stock.

The retrospective, observational cohort study evaluated the Truven MarketScan administrative claims database from 2017 to March 2019 for 4,132 adults with asthma with first-time initiation of multiple-inhaler triple therapy (mean age, 49 years; 67.9% women) and 4,393 adults with asthma and first-time discontinuation of multiple-inhaler triple therapy (mean age, 50 years; 68.4% women). All patients were followed for 6 months for discontinuation or reinitiation.

Multiple-inhaler triple therapy was defined as 1 day or more of overlapping inhaled corticosteroid (ICS), LABA and LAMA pharmacy claims. Discontinuation was defined as a 45-day or more gap in overlapping days’ supply of ICS, LABA and LAMA.

Seventy-eight percent of patients discontinued one or more component of their multiple-inhaler triple therapy and 22% of patients continued their medication 6 months after discontinuation.

Patients who discontinued their triple therapy reported more asthma symptoms, including cough (53% vs. 47.4%), wheezing (14.9% vs. 12.7%) and chest tightness (22.5% vs. 20.3%), compared with those who continued their triple therapy.

Researchers observed no differences in demographics or comorbidities between patients who discontinued or continued their multiple-inhaler triple therapy. In addition, there was no difference in history of asthma exacerbations at baseline between both patient groups.

Fewer patients who discontinued triple therapy reported six or more short-acting beta agonist claims during their baseline year compared with patients who continued their triple therapy use (12.5% vs. 16%; P = .006). Also, 72% of patients who discontinued their triple therapy used a mixture of once- and twice-daily ICS/LAMA/LABA compared with 64% of patients who continued their multiple-inhaler triple therapy.

Compared with patients who received once- and twice-daily multiple-inhaler triple therapy, risk for discontinuation was lower among patients who received once-daily ICS/LABA/LAMA therapy (HR = 0.81; 95% CI, 0.75-0.88).

Researchers also noted that nearly one-third of patients reinitiated their multiple-inhaler triple therapy with no differences in demographics compared with patients who did not reinitiate treatment.

“Multiple-inhaled triple therapy dosing regimen and the complexity of that at initiation seemed to be an independent predictor of discontinuation by 6 months, with once-daily ICS/LABA plus once-daily LAMA regimen associated with a 19% lower risk of discontinuation than the more complex regimens,” Zhang said.

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