Asthma Treatment Adherence: Once- vs Twice-Daily Regimens

Fluticasone furoate users also had a lower risk for treatment discontinuation than both budesonide and fluticasone propionate users.
Fluticasone furoate users also had a lower risk for treatment discontinuation than both budesonide and fluticasone propionate users.

This article is part of MPR's coverage of the ACAAI 2018 meeting, taking place in Seattle, Washington. Our staff will report on medical research related to allergy, asthma, and more conducted by experts in the field. Check back regularly for more news from ACCAI 2018.


SEATTLE — Patients with asthma are more likely to adhere to and less likely to discontinue treatment with once-daily fluticasone furoate/vilanterol therapy than twice-daily treatment with budesonide/formoterol or fluticasone propionate/salmeterol, according to research presented at the Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology, held November 15 to 19, 2018, in Seattle.

Investigators of this retrospective cohort study sought to compare rates of adherence to once-daily fluticasone furoate/vilanterol with rates of adherence to twice-daily budesonide/formoterol or fluticasone propionate/salmeterol in patients with asthma. From a large US claims database of patients diagnosed with asthma who initiated therapy, 3764 fluticasone furoate users were matched to budesonide users (n=3764) and 3339 fluticasone furoate users were matched to fluticasone propionate users (n=3339). Outcome measures included the mean proportion of days covered (PDC), proportion of patients achieving PDC ≥0.5 and ≥0.8, and time to treatment discontinuation.

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The results of showed the mean PDC in the fluticasone furoate/vilanterol group was significantly higher than the mean PDC in the budesonide/formoterol group (0.453 vs 0.345, adjusted P <.001) and the mean PDC in the fluticasone propionate/salmeterol group (0.446 vs 0.341, adjusted P <.001). Similarly, a greater proportion of patients who received fluticasone furoate achieved PDC ≥0.5 and ≥0.8 compared with the other 2 groups (adjusted P <.001 for all). Fluticasone furoate users had a 30% lower risk for treatment discontinuation than budesonide users (adjusted hazard ratio 0.7; 95% CI, 0.66-0.74; P <.001) and a 27% lower risk compared with fluticasone propionate users (adjusted hazard ratio 0.73; 95% CI, 0.68-0.77; P <.001).

Compared with patients who used twice-daily treatments, patients with asthma who initiated once-daily fluticasone furoate/vilanterol had higher treatment adherence and were more likely to continue with their course of therapy.  

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Reference

Averell C, Stanford R, Laliberte F, Wu J, Germain G, Duh M. Adherence with once-daily fluticasone furoate/vilanterol compared to twice-daily budesonide/formoterol or fluticasone propionate/salmeterol in asthma. Poster presented at: the Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology; November 15-19, 2018; Seattle, WA. Poster P204.