The following is the summary of “Adherence and Persistence to Single-Inhaler Versus Multiple-Inhaler Triple Therapy for Asthma Management” published in the November 2022 issue of Allergy and Clinical Immunology by Busse, et al.
Patients with uncontrolled asthma, despite inhaled corticosteroid and long-acting β2-agonist medication, are encouraged to undergo triple therapy. The triple treatment used to be administered using 3 separate inhalers. Although fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in a single inhaler has been licensed as a maintenance treatment for asthma, there is a lack of data on how well this treatment is followed through in practice. Analysis of the adherence and durability of U.S. adult asthma patients taking either a single-inhaler FF/UMEC/VI or a multiple-inhaler triple-therapy (MITT) regimen.
Patients with asthma who began using FF/UMEC/VI 100/62.5/25 mcg or MITT once a day between September 18, 2017, and September 30, 2019, were analyzed in this retrospective cohort study using data from IQVIA PharMetrics Plus. Adjusting for feature variations between the FF/UMEC/VI and MITT cohorts using inverse probability weighting and multivariate regression. The proportion of days covered (PDC) and the percentage of patients who attained PDCs of ≥0.8 and ≥0.5 were used to determine adherence. A non-persistent pattern was defined as a service void lasting more than 45 days. 1396 FF/UMEC/VI and 5,115 MITT initiators were included in the investigation.
About 3 months after beginning, FF/UMEC/VI users were more likely to be adherent (PDC ≥0 0.8; 40.6% vs. 31.3%; adjusted risk ratio [95% CI]: 1.31 [1.13-1.54]; P<.001) and had significantly higher mean PDC than MITT users (0.68 vs. 0.59; P<.001). 6 and 12 months after the program’s inception, similar trends were seen. To add, compared to MITT users, those who used FF/UMEC/VI were 49% more likely to still be using the treatment 12 months later (25.9% vs. 15.1%, adjusted hazard ratio [95% CI]: 1.49 [1.39-1.60]; P<.001). Triple therapy (FF/UMEC/VI) initiates in asthma patients have significantly higher adherence and persistence rates than MITT initiates.
Source: sciencedirect.com/science/article/pii/S2213219822005955