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Retrospective Comparison of Early versus Late Treatment with Fluticasone Propionate/Salmeterol After an Asthma Exacerbation
Journal of Asthma, 08/30/2011
Clinical Article
Hagiwara M et al. - Earlier use of fluticasone propionate/salmeterol in a single inhaler (FSC) following an asthma exacerbation was associated with reduced risk of future asthma-related exacerbation and lower use of rescue medications.
Methods- A retrospective observational cohort study compared the risk of asthma-related exacerbations [hospitalization, emergency department visit, and/or treatment with systemic corticosteroid] in patients receiving treatment with fluticasone propionate/salmeterol in a single inhaler (FSC) within 90 days following an initial asthma-related exacerbation (early treatment) versus patients receiving the treatment subsequently (late treatment).
- Data were from a large health insurance claims database spanning from January 1998 to April 2008.
- Subjects included patients with ≥1 prescription for FSC≤1 year after first asthma-related exacerbation.
- Patients with early treatment were matched to those with late treatment by propensity score and compared in terms of healthcare utilization and costs after initiation of FSC.
- A total of 14,861 patients met study inclusion criteria, including 10,793 early and 4068 late treatment patients.
- After matching, 3555 pairs were well matched on all pretreatment characteristics and duration of follow-up (mean 722 vs. 717 days, p == .634).
- Early versus late treatment was associated with longer time to first asthma-related exacerbation (hazard ratio == 0.82, 95%% CI 0.75-0.88, p < .001), fewer short-acting β-agonists prescriptions (3.3 vs. 3.6, p == .031), higher outpatient yearly per patient pharmacy costs ($1320 vs. $1163, p == .008), and lower yearly per patient asthma-related emergency department visit costs ($80 vs. $105, p == .032).
- Total yearly per patient asthma-related costs were similar ($2197 vs. $2064, p == .203).