Effect of Individual Patient Characteristics and Treatment Choices on Reliever Medication Use in Moderate-Severe Asthma : A Poisson Analysis of Randomised Clinical Trials
© 2024. The Author(s)..
INTRODUCTION: Even though increased use of reliever medication, including short-acting beta agonists (SABA), provides an indirect measure of symptom worsening, there have been limited efforts to assess how different patterns of reliever use correlate with symptom control and future risk of exacerbations. Here, we evaluate the effect of individual baseline characteristics on reliever use in patients with moderate-severe asthma on regular maintenance therapy with fluticasone propionate (FP) or combination therapy with fluticasone propionate/salmeterol (FP/SAL) or budesonide/formoterol (BUD/FOR).
METHODS: A drug-disease model describing the number of 24-h puffs and overnight occasions was developed with data from five clinical studies (N = 6212). The model was implemented using a nonlinear mixed effects approach and a Poisson function, considering clinical and demographic baseline characteristics. Goodness of fit and model predictive performance were assessed. Heatmaps were created to summarise the effect of concurrent baseline factors on reliever utilisation.
RESULTS: The final model accurately described individual patterns of reliever use, which is significantly increased with time since diagnosis, smoking, higher Asthma Control Questionnaire (ACQ-5) score and higher body mass index (BMI) at baseline. Whilst the number of puffs decreases slowly after an initial drop relative to the start of treatment, exacerbating patients utilise significantly more reliever than those who do not exacerbate. The mean effect of FP/SAL (median dose: 250/50 μg BID) on reliever use was slightly higher than that of BUD/FOR (median dose: 160/4.5 μg BID), i.e. a 75.3% vs 69.3% reduction in reliever use, respectively.
CONCLUSIONS: The availability of individual-level patient data in conjunction with a parametric approach enabled the characterisation of interindividual differences in the patterns of reliever use in patients with moderate-severe asthma. Taken together, individual demographic and clinical characteristics, as well as exacerbation history, can be considered an indicator of the degree of asthma control. High SABA reliever use suggests suboptimal clinical management of patients on maintenance therapy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
|---|---|
| Enthalten in: |
Advances in therapy - 41(2024), 3 vom: 25. März, Seite 1201-1225 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
van Dijkman, Sven C [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 22.02.2024 Date Revised 06.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s12325-023-02774-w |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36786228X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36786228X | ||
| 003 | DE-627 | ||
| 005 | 20240306232814.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240201s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12325-023-02774-w |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1318.xml |
| 035 | |a (DE-627)NLM36786228X | ||
| 035 | |a (NLM)38296921 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a van Dijkman, Sven C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effect of Individual Patient Characteristics and Treatment Choices on Reliever Medication Use in Moderate-Severe Asthma |b A Poisson Analysis of Randomised Clinical Trials |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 22.02.2024 | ||
| 500 | |a Date Revised 06.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a INTRODUCTION: Even though increased use of reliever medication, including short-acting beta agonists (SABA), provides an indirect measure of symptom worsening, there have been limited efforts to assess how different patterns of reliever use correlate with symptom control and future risk of exacerbations. Here, we evaluate the effect of individual baseline characteristics on reliever use in patients with moderate-severe asthma on regular maintenance therapy with fluticasone propionate (FP) or combination therapy with fluticasone propionate/salmeterol (FP/SAL) or budesonide/formoterol (BUD/FOR) | ||
| 520 | |a METHODS: A drug-disease model describing the number of 24-h puffs and overnight occasions was developed with data from five clinical studies (N = 6212). The model was implemented using a nonlinear mixed effects approach and a Poisson function, considering clinical and demographic baseline characteristics. Goodness of fit and model predictive performance were assessed. Heatmaps were created to summarise the effect of concurrent baseline factors on reliever utilisation | ||
| 520 | |a RESULTS: The final model accurately described individual patterns of reliever use, which is significantly increased with time since diagnosis, smoking, higher Asthma Control Questionnaire (ACQ-5) score and higher body mass index (BMI) at baseline. Whilst the number of puffs decreases slowly after an initial drop relative to the start of treatment, exacerbating patients utilise significantly more reliever than those who do not exacerbate. The mean effect of FP/SAL (median dose: 250/50 μg BID) on reliever use was slightly higher than that of BUD/FOR (median dose: 160/4.5 μg BID), i.e. a 75.3% vs 69.3% reduction in reliever use, respectively | ||
| 520 | |a CONCLUSIONS: The availability of individual-level patient data in conjunction with a parametric approach enabled the characterisation of interindividual differences in the patterns of reliever use in patients with moderate-severe asthma. Taken together, individual demographic and clinical characteristics, as well as exacerbation history, can be considered an indicator of the degree of asthma control. High SABA reliever use suggests suboptimal clinical management of patients on maintenance therapy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Asthma symptom control | |
| 650 | 4 | |a Drug-disease modelling | |
| 650 | 4 | |a Exacerbation | |
| 650 | 4 | |a ICS/LABA combination therapy | |
| 650 | 4 | |a Inhaled corticosteroids | |
| 650 | 4 | |a Reliever medication | |
| 650 | 4 | |a Rescue medication | |
| 650 | 4 | |a SABA | |
| 650 | 4 | |a Short-acting beta agonists | |
| 650 | 7 | |a Anti-Asthmatic Agents |2 NLM | |
| 650 | 7 | |a Bronchodilator Agents |2 NLM | |
| 650 | 7 | |a Budesonide, Formoterol Fumarate Drug Combination |2 NLM | |
| 650 | 7 | |a Drug Combinations |2 NLM | |
| 650 | 7 | |a Fluticasone |2 NLM | |
| 650 | 7 | |a CUT2W21N7U |2 NLM | |
| 650 | 7 | |a Formoterol Fumarate |2 NLM | |
| 650 | 7 | |a W34SHF8J2K |2 NLM | |
| 700 | 1 | |a Yorgancıoğlu, Arzu |e verfasserin |4 aut | |
| 700 | 1 | |a Pavord, Ian |e verfasserin |4 aut | |
| 700 | 1 | |a Brusselle, Guy |e verfasserin |4 aut | |
| 700 | 1 | |a Pitrez, Paulo M |e verfasserin |4 aut | |
| 700 | 1 | |a Oosterholt, Sean |e verfasserin |4 aut | |
| 700 | 1 | |a Fumali, Sourabh |e verfasserin |4 aut | |
| 700 | 1 | |a Majumdar, Anurita |e verfasserin |4 aut | |
| 700 | 1 | |a Della Pasqua, Oscar |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Advances in therapy |d 1990 |g 41(2024), 3 vom: 25. März, Seite 1201-1225 |w (DE-627)NLM085859427 |x 1865-8652 |7 nnns |
| 773 | 1 | 8 | |g volume:41 |g year:2024 |g number:3 |g day:25 |g month:03 |g pages:1201-1225 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s12325-023-02774-w |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 41 |j 2024 |e 3 |b 25 |c 03 |h 1201-1225 | ||