Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management
Abstract Background Choosing effective devices (inhaled corticosteroid [ICS]-long-acting β2 agonist [LABA] combination inhalers) as maintenance treatment is critical for managing patients with asthma. We aimed to compare ICS/LABA combination efficacy, safety, and adherence across inhaler types and c...
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BMC
2025-01-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-024-03084-7 |
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| author | Hee Sun Park Jungkuk Lee Hasung Kim Seong-Dae Woo |
| author_facet | Hee Sun Park Jungkuk Lee Hasung Kim Seong-Dae Woo |
| author_sort | Hee Sun Park |
| collection | DOAJ |
| description | Abstract Background Choosing effective devices (inhaled corticosteroid [ICS]-long-acting β2 agonist [LABA] combination inhalers) as maintenance treatment is critical for managing patients with asthma. We aimed to compare ICS/LABA combination efficacy, safety, and adherence across inhaler types and components in patients newly diagnosed with asthma. Methods Utilizing South Korea’s National Health Insurance Service data, we conducted a population-based cohort study involving patients aged 18–80 years, newly diagnosed with asthma who received ICS/LABA combination therapy between January 2016 and December 2020. Outcomes assessed included treatment adherence, asthma exacerbations, hospitalizations, emergency-department visits, mortality, and safety outcomes within 3-month and 1-year post-index periods. Results Overall, 13,850 eligible patients were included, with subgroups categorized and compared according to inhaler type and component (metered dose inhalers [MDIs] vs. dry powder inhalers [DPIs], budesonide vs. fluticasone, and formoterol vs. salmeterol). Efficacy and safety profiles did not significantly differ across device types or ICS/LABA combination components during the 3-month and 1-year follow-up periods. However, the DPI group exhibited a significantly higher mean proportion of days covered (0.67 ± 0.23 vs. 0.62 ± 0.23; P < 0.001) and a lower risk of discontinuation (adjusted hazard ratio, 0.867; 95% confidence interval, 0.804–0.927; P < 0.001) than did the MDI group, with no significant differences observed between the other subgroups. Conclusions The choice of inhaler device (MDI vs. DPI) and specific ICS/LABA combination components does not significantly impact efficacy and safety profiles in patients newly diagnosed with asthma. However, DPI use may be associated with improved adherence. These results provide valuable insights for clinicians in selecting appropriate and individually tailored inhaler therapies in real-world settings. Graphical abstract |
| format | Article |
| id | doaj-art-0ca034688c314656b79c26061001122e |
| institution | Kabale University |
| issn | 1465-993X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj-art-0ca034688c314656b79c26061001122e2025-01-19T12:36:31ZengBMCRespiratory Research1465-993X2025-01-0126111110.1186/s12931-024-03084-7Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma managementHee Sun Park0Jungkuk Lee1Hasung Kim2Seong-Dae Woo3Department of Pulmonary, Allergy, and Critical Care Medicine, Chungnam National University School of MedicineData Science Team, Hanmi Pharm. Co., LtdData Science Team, Hanmi Pharm. Co., LtdDepartment of Pulmonary, Allergy, and Critical Care Medicine, Chungnam National University School of MedicineAbstract Background Choosing effective devices (inhaled corticosteroid [ICS]-long-acting β2 agonist [LABA] combination inhalers) as maintenance treatment is critical for managing patients with asthma. We aimed to compare ICS/LABA combination efficacy, safety, and adherence across inhaler types and components in patients newly diagnosed with asthma. Methods Utilizing South Korea’s National Health Insurance Service data, we conducted a population-based cohort study involving patients aged 18–80 years, newly diagnosed with asthma who received ICS/LABA combination therapy between January 2016 and December 2020. Outcomes assessed included treatment adherence, asthma exacerbations, hospitalizations, emergency-department visits, mortality, and safety outcomes within 3-month and 1-year post-index periods. Results Overall, 13,850 eligible patients were included, with subgroups categorized and compared according to inhaler type and component (metered dose inhalers [MDIs] vs. dry powder inhalers [DPIs], budesonide vs. fluticasone, and formoterol vs. salmeterol). Efficacy and safety profiles did not significantly differ across device types or ICS/LABA combination components during the 3-month and 1-year follow-up periods. However, the DPI group exhibited a significantly higher mean proportion of days covered (0.67 ± 0.23 vs. 0.62 ± 0.23; P < 0.001) and a lower risk of discontinuation (adjusted hazard ratio, 0.867; 95% confidence interval, 0.804–0.927; P < 0.001) than did the MDI group, with no significant differences observed between the other subgroups. Conclusions The choice of inhaler device (MDI vs. DPI) and specific ICS/LABA combination components does not significantly impact efficacy and safety profiles in patients newly diagnosed with asthma. However, DPI use may be associated with improved adherence. These results provide valuable insights for clinicians in selecting appropriate and individually tailored inhaler therapies in real-world settings. Graphical abstracthttps://doi.org/10.1186/s12931-024-03084-7AdherenceAsthmaEfficacy and safetyICS/LABA combinationsInhaler typesReal-world outcomes |
| spellingShingle | Hee Sun Park Jungkuk Lee Hasung Kim Seong-Dae Woo Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management Respiratory Research Adherence Asthma Efficacy and safety ICS/LABA combinations Inhaler types Real-world outcomes |
| title | Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management |
| title_full | Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management |
| title_fullStr | Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management |
| title_full_unstemmed | Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management |
| title_short | Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management |
| title_sort | comparative analysis of real world data on the efficacy and safety of and adherence to ics laba combinations in asthma management |
| topic | Adherence Asthma Efficacy and safety ICS/LABA combinations Inhaler types Real-world outcomes |
| url | https://doi.org/10.1186/s12931-024-03084-7 |
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