Adherence and Persistence to Single-Inhaler Versus Multiple-Inhaler Triple Therapy for Asthma Management.

Abstract

BACKGROUND:

Treatment guidelines recommend triple therapy for patients with asthma who remain uncontrolled on inhaled corticosteroid/long-acting β2-agonist therapy. Previously, triple therapy was only available via multiple inhalers. Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) is approved as maintenance treatment for asthma; however, real-world information on adherence and persistence is limited.

OBJECTIVE:

To compare adherence and persistence among adult patients with asthma receiving single-inhaler FF/UMEC/VI versus multiple-inhaler triple therapy (MITT) in the United States.

METHODS:

This retrospective cohort study used IQVIA PharMetrics Plus data to evaluate patients with asthma who initiated once-daily FF/UMEC/VI 100/62.5/25 mcg or MITT between September 18, 2017, and September 30, 2019. Inverse probability weighting and multivariable regression adjusted for differences in characteristics between the FF/UMEC/VI and MITT cohorts. Adherence was assessed using proportion of days covered (PDC) and proportion of patients achieving PDC ≥0.8 and PDC ≥0.5. Non-persistence was identified as a >45-day gap between fills.

RESULTS:

The study included 1396 FF/UMEC/VI and 5115 MITT initiators. Three months after initiation, FF/UMEC/VI users had significantly higher mean PDC versus MITT users (0.68 vs 0.59; P < .001) and 31% more likely to be adherent (PDC ≥0.8; 40.6% vs 31.3%; adjusted risk ratio [95% confidence interval (CI)]: 1.31 [1.13-1.54]; P < .001). Similar patterns were observed at 6 and 12 months post initiation. In addition, FF/UMEC/VI users were 49% more likely to persist at 12 months than MITT users (25.9% vs 15.1%, adjusted hazard ratio [95% CI]: 1.49 [1.39-1.60]; P < .001).

CONCLUSIONS:

Patients with asthma initiating triple therapy with FF/UMEC/VI had significantly better adherence and persistence compared with MITT initiators.

• Authors: William W Busse, Carl B Abbott, Guillaume Germain, François Laliberté, Sean D MacKnight, Young Jung, Mei Sheng Duh, Carlyne M Averell
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) Vol. 10 Issue 11 Pg. 2904-2913.e6 (11 2022) ISSN: 2213-2201 [Electronic] United States
• PMID: 35752431 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Drug Combinations
• vilanterol
• Chlorobenzenes
• Benzyl Alcohols
• Fluticasone
• Bronchodilator Agents
• Androstadienes

Topics

• Adult
• Humans
• Retrospective Studies
• Administration, Inhalation
• Pulmonary Disease, Chronic Obstructive (drug therapy)
• Drug Combinations
• Chlorobenzenes (therapeutic use)
• Benzyl Alcohols (therapeutic use)
• Nebulizers and Vaporizers
• Fluticasone (therapeutic use)
• Asthma (drug therapy, chemically induced)
• Bronchodilator Agents (therapeutic use)
• Androstadienes