Cargando…

Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years

Asthma affects more than 300 million people in the world, costs over $80 billion annually in the United States, and is efficaciously treated with inhaled corticosteroids (ICS). To our knowledge, no studies have examined the real-world effectiveness of ICS, including the combination therapy consistin...

Descripción completa

Detalles Bibliográficos
Autores principales: McGeachie, Michael J., Wang, Alberta L., Lutz, Sharon M., Sordillo, Joanne E., Weiss, Scott T., Tantisira, Kelan G., Iribarren, Carlos, Lu, Meng X., Wu, Ann Chen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141292/
https://www.ncbi.nlm.nih.gov/pubmed/32197337
http://dx.doi.org/10.3390/jcm9030819
_version_ 1783519165883088896
author McGeachie, Michael J.
Wang, Alberta L.
Lutz, Sharon M.
Sordillo, Joanne E.
Weiss, Scott T.
Tantisira, Kelan G.
Iribarren, Carlos
Lu, Meng X.
Wu, Ann Chen
author_facet McGeachie, Michael J.
Wang, Alberta L.
Lutz, Sharon M.
Sordillo, Joanne E.
Weiss, Scott T.
Tantisira, Kelan G.
Iribarren, Carlos
Lu, Meng X.
Wu, Ann Chen
author_sort McGeachie, Michael J.
collection PubMed
description Asthma affects more than 300 million people in the world, costs over $80 billion annually in the United States, and is efficaciously treated with inhaled corticosteroids (ICS). To our knowledge, no studies have examined the real-world effectiveness of ICS, including the combination therapy consisting of ICS and long-acting beta agonists (LABAs), and patterns of use over a 15-year time period. We used data from the Kaiser Permanente Northern California multi-ethnic Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort which comprises longitudinal electronic health record data of over 100,000 people. Data included longitudinal asthma-related events, such as ambulatory office visits, hospitalizations, emergency department (ED) visits, and fills of ICS and ICS–LABA combination. Asthma exacerbations were defined as an asthma-related ED visit, hospitalization, or oral corticosteroid (OCS) burst. We used an expected-value approach to determine ICS and ICS–LABA coverage over exacerbation events. We compared rates of exacerbation of subjects on ICS or ICS–LABAs to their own rates of exacerbation when off controller medications. We found ICS–LABA therapy had significant effects, reducing all types of exacerbations per day by a factor of 1.76 (95% CI (1.06, 2.93), p = 0.03) and, specifically, bursts per day by a factor of 1.91 (95% CI (1.04, 3.53), p = 0.037). In conclusion, ICS–LABA therapy was significantly associated with fewer asthma-related exacerbations in a large population of individuals with asthma who were followed for 15 years.
format Online
Article
Text
id pubmed-7141292
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-71412922020-04-10 Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years McGeachie, Michael J. Wang, Alberta L. Lutz, Sharon M. Sordillo, Joanne E. Weiss, Scott T. Tantisira, Kelan G. Iribarren, Carlos Lu, Meng X. Wu, Ann Chen J Clin Med Article Asthma affects more than 300 million people in the world, costs over $80 billion annually in the United States, and is efficaciously treated with inhaled corticosteroids (ICS). To our knowledge, no studies have examined the real-world effectiveness of ICS, including the combination therapy consisting of ICS and long-acting beta agonists (LABAs), and patterns of use over a 15-year time period. We used data from the Kaiser Permanente Northern California multi-ethnic Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort which comprises longitudinal electronic health record data of over 100,000 people. Data included longitudinal asthma-related events, such as ambulatory office visits, hospitalizations, emergency department (ED) visits, and fills of ICS and ICS–LABA combination. Asthma exacerbations were defined as an asthma-related ED visit, hospitalization, or oral corticosteroid (OCS) burst. We used an expected-value approach to determine ICS and ICS–LABA coverage over exacerbation events. We compared rates of exacerbation of subjects on ICS or ICS–LABAs to their own rates of exacerbation when off controller medications. We found ICS–LABA therapy had significant effects, reducing all types of exacerbations per day by a factor of 1.76 (95% CI (1.06, 2.93), p = 0.03) and, specifically, bursts per day by a factor of 1.91 (95% CI (1.04, 3.53), p = 0.037). In conclusion, ICS–LABA therapy was significantly associated with fewer asthma-related exacerbations in a large population of individuals with asthma who were followed for 15 years. MDPI 2020-03-18 /pmc/articles/PMC7141292/ /pubmed/32197337 http://dx.doi.org/10.3390/jcm9030819 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
McGeachie, Michael J.
Wang, Alberta L.
Lutz, Sharon M.
Sordillo, Joanne E.
Weiss, Scott T.
Tantisira, Kelan G.
Iribarren, Carlos
Lu, Meng X.
Wu, Ann Chen
Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years
title Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years
title_full Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years
title_fullStr Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years
title_full_unstemmed Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years
title_short Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years
title_sort real-life patterns of exacerbations while on inhaled corticosteroids and long-acting beta agonists for asthma over 15 years
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141292/
https://www.ncbi.nlm.nih.gov/pubmed/32197337
http://dx.doi.org/10.3390/jcm9030819
work_keys_str_mv AT mcgeachiemichaelj reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT wangalbertal reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT lutzsharonm reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT sordillojoannee reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT weissscottt reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT tantisirakelang reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT iribarrencarlos reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT lumengx reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years
AT wuannchen reallifepatternsofexacerbationswhileoninhaledcorticosteroidsandlongactingbetaagonistsforasthmaover15years