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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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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 |
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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 |
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