Cargando…

Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management

INTRODUCTION: Pharmacological asthma management focuses on the use of inhaled corticosteroid (ICS)-containing therapies, which reduce airway inflammation and provide bronchoprotection, improving symptom control and reducing exacerbation risk. ICS underuse due to poor adherence is common, leading to...

Descripción completa

Detalles Bibliográficos
Autores principales: Daley-Yates, Peter, Singh, Dave, Igea, Juan M., Macchia, Luigi, Verma, Manish, Berend, Norbert, Plank, Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427546/
https://www.ncbi.nlm.nih.gov/pubmed/37438554
http://dx.doi.org/10.1007/s12325-023-02585-z
_version_ 1785090267647311872
author Daley-Yates, Peter
Singh, Dave
Igea, Juan M.
Macchia, Luigi
Verma, Manish
Berend, Norbert
Plank, Maximilian
author_facet Daley-Yates, Peter
Singh, Dave
Igea, Juan M.
Macchia, Luigi
Verma, Manish
Berend, Norbert
Plank, Maximilian
author_sort Daley-Yates, Peter
collection PubMed
description INTRODUCTION: Pharmacological asthma management focuses on the use of inhaled corticosteroid (ICS)-containing therapies, which reduce airway inflammation and provide bronchoprotection, improving symptom control and reducing exacerbation risk. ICS underuse due to poor adherence is common, leading to poor clinical outcomes including increased risk of mortality. This article reviews efficacy versus systemic activity profiles for various adherence patterns and dosing regimens of fluticasone furoate (FF)-containing and budesonide (BUD)-containing asthma therapies in clinical trials and real-world studies. METHODS: We performed a structured literature review (1 January 2000–3 March 2022) and mathematical modelling analysis of FF-containing and BUD-containing regular daily dosing in patients with mild-to-severe asthma, as-needed BUD/formoterol (FOR) in mild asthma, and BUD/FOR maintenance and reliever therapy (MART) dosing in moderate-to-severe asthma, to assess efficacy (bronchoprotection) and systemic activity (cortisol suppression) profiles of dosing patterns of ICS use in multiple adherence scenarios. RESULTS: A total of 22 manuscripts were included in full-text review and 18 in the model simulations. Focusing on FF-containing or BUD-containing treatments at comparable adherence rates, regular daily FF or FF/vilanterol (VI) dosing provided more prolonged bronchoprotection and fewer systemic effects than daily BUD, daily BUD/FOR, or BUD/FOR MART dosing, especially in low adherence scenarios. In model simulations and the real-world setting, FF/VI generally provided longer bronchoprotection, lower systemic activity, and greater clinical benefits over BUD/FOR as well as consistently higher adherence. CONCLUSION: In this literature review and modelling analysis, FF/VI was found to show clinical advantages on asthma control over BUD/FOR. These findings have implications for helping clinicians select the most suitable inhaled therapy for their patients with asthma. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-023-02585-z.
format Online
Article
Text
id pubmed-10427546
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer Healthcare
record_format MEDLINE/PubMed
spelling pubmed-104275462023-08-17 Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management Daley-Yates, Peter Singh, Dave Igea, Juan M. Macchia, Luigi Verma, Manish Berend, Norbert Plank, Maximilian Adv Ther Original Research INTRODUCTION: Pharmacological asthma management focuses on the use of inhaled corticosteroid (ICS)-containing therapies, which reduce airway inflammation and provide bronchoprotection, improving symptom control and reducing exacerbation risk. ICS underuse due to poor adherence is common, leading to poor clinical outcomes including increased risk of mortality. This article reviews efficacy versus systemic activity profiles for various adherence patterns and dosing regimens of fluticasone furoate (FF)-containing and budesonide (BUD)-containing asthma therapies in clinical trials and real-world studies. METHODS: We performed a structured literature review (1 January 2000–3 March 2022) and mathematical modelling analysis of FF-containing and BUD-containing regular daily dosing in patients with mild-to-severe asthma, as-needed BUD/formoterol (FOR) in mild asthma, and BUD/FOR maintenance and reliever therapy (MART) dosing in moderate-to-severe asthma, to assess efficacy (bronchoprotection) and systemic activity (cortisol suppression) profiles of dosing patterns of ICS use in multiple adherence scenarios. RESULTS: A total of 22 manuscripts were included in full-text review and 18 in the model simulations. Focusing on FF-containing or BUD-containing treatments at comparable adherence rates, regular daily FF or FF/vilanterol (VI) dosing provided more prolonged bronchoprotection and fewer systemic effects than daily BUD, daily BUD/FOR, or BUD/FOR MART dosing, especially in low adherence scenarios. In model simulations and the real-world setting, FF/VI generally provided longer bronchoprotection, lower systemic activity, and greater clinical benefits over BUD/FOR as well as consistently higher adherence. CONCLUSION: In this literature review and modelling analysis, FF/VI was found to show clinical advantages on asthma control over BUD/FOR. These findings have implications for helping clinicians select the most suitable inhaled therapy for their patients with asthma. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-023-02585-z. Springer Healthcare 2023-07-12 2023 /pmc/articles/PMC10427546/ /pubmed/37438554 http://dx.doi.org/10.1007/s12325-023-02585-z Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Daley-Yates, Peter
Singh, Dave
Igea, Juan M.
Macchia, Luigi
Verma, Manish
Berend, Norbert
Plank, Maximilian
Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management
title Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management
title_full Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management
title_fullStr Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management
title_full_unstemmed Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management
title_short Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management
title_sort assessing the effects of changing patterns of inhaled corticosteroid dosing and adherence with fluticasone furoate and budesonide on asthma management
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427546/
https://www.ncbi.nlm.nih.gov/pubmed/37438554
http://dx.doi.org/10.1007/s12325-023-02585-z
work_keys_str_mv AT daleyyatespeter assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement
AT singhdave assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement
AT igeajuanm assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement
AT macchialuigi assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement
AT vermamanish assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement
AT berendnorbert assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement
AT plankmaximilian assessingtheeffectsofchangingpatternsofinhaledcorticosteroiddosingandadherencewithfluticasonefuroateandbudesonideonasthmamanagement