scholarly journals PRS35 EFFECT OF THE REPLACEMENT OF INHALED CORTICOSTEROIDS BY LONG-ACTING ANTICHOLINERGICS IN DUAL THERAPY ON HEALTH OUTCOMES IN PATIENTS WITH COPD: A REAL-LIFE RETROSPECTIVE STUDY

2019 ◽  
Vol 22 ◽  
pp. S355
Author(s):  
A. Sicras-Mainar ◽  
R. Navarro-Artieda ◽  
J.L. Enriquez
Keyword(s):  
Retrospective Study ◽  
Health Outcomes ◽  
Inhaled Corticosteroids ◽  
Real Life ◽  
Dual Therapy ◽  
Long Acting

Utilization Patterns and Trends in The Use of Medications for Asthma Control in a Cohort of Colombian Patients, 2017-2019. v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Retrospective Study ◽  
General Practitioner ◽  
Health System ◽  
Triple Therapy ◽  
Inhaled Corticosteroids ◽  
Prescription Patterns ◽  
Utilization Patterns ◽  
Control Therapy ◽  
Long Acting

Objective:To determine the trend in the use of medications used to treat asthma in a group of patients affiliated to the Colombian health system. Methods:A retrospective study on prescription patterns of medications used to treat asthma in patients over 5 years of age between 2017 and 2019. Sociodemographic variables, medications used and combinations, persistence of use and prescribing physician were considered. Results:10,706 people with a diagnosis of asthma were identified, with predominance in female sex (56.8 %), median age 32.2 ± 26.1 years. At the start of follow-up, 53.2% of patients aged 5-11 years were receiving monotherapy, mean 1.5 ± 0.6 drugs/patient, especially inhaled corticosteroids (ICS; 55.9%) and short-acting β-agonists (SABA; 55.6%). Moreover, in patients older than 12 years, 53.5% were treated in monotherapy, mean 1.6 ± 0.7 drugs/patient, of which 45.9% were on SABA, and 37.1 % on ICS.Between 63.0% and 83.6% of patients were treated by a general practitioner. The proportion of patients on the ICS/ long-acting β-agonists (LABA) combination grew at 24 months follow-up by 411% and 177%, respectively. 12.5% of patients (495) received triple therapy (ICS/LABA+LAMA [long-acting anticholinergics]), particularly with fluticasone/salmeterol+tiotropium. Conclusions:Patients with a diagnosis of asthma older than 5 years in Colombia are mainly receiving control therapy with ICS, alone or combined with SAMA and, to a lesser extent, with LABA.

scholarly journals Maintained therapeutic effect of revefenacin over 52 weeks in moderate to very severe Chronic Obstructive Pulmonary Disease (COPD)

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
James F. Donohue ◽  
Edward Kerwin ◽  
Sanjay Sethi ◽  
Brett Haumann ◽  
Srikanth Pendyala ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Outcomes ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Open Label ◽  
Double Blind ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Abstract Background Revefenacin is a long-acting muscarinic antagonist that was recently approved for the nebulized treatment of chronic obstructive pulmonary disease (COPD). Although shorter duration studies have documented the efficacy of revefenacin in COPD, longer-term efficacy has not been described. In a recent 52-week safety trial, revefenacin was well tolerated and had a favorable benefit-risk profile. Here we report exploratory efficacy and health outcomes in patients receiving revefenacin 175 μg or 88 μg daily during the 52-week trial. Methods In this randomized, parallel-group, 52-week trial (NCT02518139), 1055 participants with moderate to very severe COPD received revefenacin 175 μg or 88 μg in a double-blind manner, or open-label active control tiotropium. Results Over the 52-week treatment period, both doses of revefenacin, as well as tiotropium, elicited significant (all p < 0.0003) improvements from baseline in trough forced expiratory volume in 1 s (FEV1). The trough FEV1 profile (least squares mean change from baseline) for revefenacin 175 μg ranged from 52.3–124.3 mL and the trough FEV1 profile for tiotropium ranged from 79.7–112.8 mL. In subgroup comparisons, the effect of revefenacin on trough FEV1 was comparable in patients taking concomitant long-acting β-agonists, with or without inhaled corticosteroids, with patients who were not taking these medications. There were statistically significant (p < 0.05) improvements in all measured health status outcomes (evaluated using St. George’s Respiratory Questionnaire, COPD Assessment Test, Clinical COPD Questionnaire and Baseline and Transition Dyspnea Index) from 3 months onward, in all treatment arms. Conclusions Significant sustained improvements from baseline in trough FEV1 and respiratory health outcomes were demonstrated for 175-μg revefenacin over 52 weeks, further supporting its use as a once-daily bronchodilator for the nebulized treatment of patients with COPD. Trial registration NCT02518139; Registered 5 August 2015.

scholarly journals Evaluation of Dual Therapy in Real Life Setting in Treatment-Naïve Turkish Patients with HCV Infection: A Multicenter, Retrospective Study

2016 ◽  
Vol 33 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Yunus Gurbuz ◽  
Necla Eren Tulek ◽  
Emin Ediz Tutuncu ◽  
Suda Tekin Koruk ◽  
Bilgehan Aygen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Real Life ◽  
Dual Therapy ◽  
Hcv Infection ◽  
Real Life Setting ◽  
Treatment Naïve ◽  
Turkish Patients

scholarly journals ICS/formoterol in the management of asthma in the clinical practice of pulmonologists: an international survey on GINA strategy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Álvaro A. Cruz ◽  
Sara Barile ◽  
Elena Nudo ◽  
Laura Brogelli ◽  
Patricia Guller ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Real Life ◽  
Dissemination And Implementation ◽  
International Survey ◽  
Safety Issues ◽  
Beta 2 ◽  
Global Initiative ◽  
Long Acting

Abstract Background The treatment with short-acting beta-2 agonists (SABA) alone is no longer recommended due to safety issues. Instead, the current Global Initiative for Asthma (GINA) Report recommends the use of the combination of inhaled corticosteroids (ICS) with the rapid/long-acting beta-2 agonist formoterol, although the use in steps 1 and 2 is still off-label in the EU and in many countries. It is important to understand clinicians’ knowledge and opinions on the issue with the ultimate goal to encourage the implementation of the new approach in clinical practice. Methods We performed an international survey, directed to pulmonologists interested in the management of patients with asthma. Results Most participants reported that SABA alone should not be used in GINA Step 1 asthma treatment. As-needed low-dose ICS/formoterol combination to patients in step 1, and as-needed low-dose ICS/formoterol as reliever therapy in any step were found to be of current use prescribed in their real-life settings. SABA alone was still prescribed to a proportion of patients, although the pulmonologists’ opinion was that it should no longer be used. Conclusions Most specialists are up to date and understand the relevance of the changes in GINA reports from 2019. Nevertheless, dissemination and implementation of GINA novel management strategy is still needed.

scholarly journals Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years

2020 ◽  
Vol 9 (3) ◽  
pp. 819 ◽  
Author(s):  
Michael J. McGeachie ◽  
Alberta L. Wang ◽  
Sharon M. Lutz ◽  
Joanne E. Sordillo ◽  
Scott T. Weiss ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Large Population ◽  
Real Life ◽  
The United States ◽  
Adult Health ◽  
Office Visits ◽  
Electronic Health Record Data ◽  
Kaiser Permanente ◽  
Beta Agonists ◽  
Long Acting

Asthma affects more than 300 million people in the world, costs over $80 billion annually in the United States, and is efficaciously treated with inhaled corticosteroids (ICS). To our knowledge, no studies have examined the real-world effectiveness of ICS, including the combination therapy consisting of ICS and long-acting beta agonists (LABAs), and patterns of use over a 15-year time period. We used data from the Kaiser Permanente Northern California multi-ethnic Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort which comprises longitudinal electronic health record data of over 100,000 people. Data included longitudinal asthma-related events, such as ambulatory office visits, hospitalizations, emergency department (ED) visits, and fills of ICS and ICS–LABA combination. Asthma exacerbations were defined as an asthma-related ED visit, hospitalization, or oral corticosteroid (OCS) burst. We used an expected-value approach to determine ICS and ICS–LABA coverage over exacerbation events. We compared rates of exacerbation of subjects on ICS or ICS–LABAs to their own rates of exacerbation when off controller medications. We found ICS–LABA therapy had significant effects, reducing all types of exacerbations per day by a factor of 1.76 (95% CI (1.06, 2.93), p = 0.03) and, specifically, bursts per day by a factor of 1.91 (95% CI (1.04, 3.53), p = 0.037). In conclusion, ICS–LABA therapy was significantly associated with fewer asthma-related exacerbations in a large population of individuals with asthma who were followed for 15 years.

scholarly journals Cost-utility of triple versus dual inhaler therapy in moderate to severe asthma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jefferson Antonio Buendía ◽  
Diana Guerrero Patiño
Keyword(s):  
Cost Effectiveness ◽  
Triple Therapy ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Dual Therapy ◽  
Lifetime Horizon ◽  
Discounted Cost ◽  
Life Years ◽  
Long Acting ◽  
The Cost

Abstract Background An important proportion of asthma patients remain uncontrolled despite using inhaled corticosteroids and long-acting beta-agonists. Clinical guidelines recommend, in these patients, using add-on long-acting muscarinic antagonists (triple therapy) to treatment with high doses of inhaled corticosteroids-long-acting beta2-agonist (dual therapy). The purpose of this study was to assess the cost-effectiveness of triple therapy versus dual therapy for patients with severe asthma. Methods A probabilistic Markov model was created to estimate the cost and quality-adjusted life-years (QALYs) of patients with severe asthma in Colombia. Total costs and QALYS of dual and triple therapy were calculated over a lifetime horizon. Multiple sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay value of $19,000. Results The model suggests a potential gain of 1.55 QALYs per patient per year on triple therapy with respect to dual therapy. We observed a difference of US$304 in discounted cost per person-year on triple therapy with respect to dual therapy. The incremental cost-effectiveness ratio was US$196 in the probabilistic model. In the sensitivity analysis, our base‐case results were robust to variations in all assumptions and parameters. Conclusion In conclusion, triple therapy in patients with moderate-severe asthma was cost-effective. Using triple therapy emerges with our results as an alternative before using oral corticosteroids or biologics, especially in resource-limited settings.

Impact of Long-Acting Bronchodilators and Exposure to Inhaled Corticosteroids on Mortality in COPD: A Real-Life Retrospective Cohort Study

Lung ◽  
2014 ◽  
Vol 192 (5) ◽  
pp. 649-652 ◽  
Author(s):  
Arvind Manoharan ◽  
Phillip M. Short ◽  
William J. Anderson ◽  
Brian J. Lipworth
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Inhaled Corticosteroids ◽  
Real Life ◽  
Long Acting
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