Demographics, Treatment Patterns, and Morbidity in Patients with Exercise-Induced Bronchoconstriction: An Administrative Claims Data Analysis

PURPOSE: Exercise-induced bronchoconstriction (EIB) is generally treated with short-acting β(2)-agonists (SABA) before exercising, to prevent symptoms. Real-world data on treatments and outcomes for patients with EIB alone (EIB(alone)), or with asthma (EIB(asthma)), in the USA are limited. This study compared demographics, treatment patterns, morbidity, and costs of treating EIB between these two groups of patients. PATIENTS AND METHODS: Administrative claims from US IBM(®) MarketScan(®) Research databases were analyzed retrospectively. Patients aged ≥4 years filling a SABA claim between 1/1/2011 and 12/31/2016 were evaluated. Patients were indexed on a random SABA claim and required to have 12 months’ continuous eligibility pre- and post-index, ≥1 maintenance medication and/or SABA fill post-index, and were designated EIB(alone) or EIB(asthma) according to diagnostic codes (EIB only or EIB plus asthma, respectively). Descriptive statistics were used. RESULTS: In total, 13,480 patients had EIB(alone) and 14,862 had EIB(asthma). Compared with EIB(asthma), the EIB(alone) group was older (mean[SD] 20.4[13.6] vs 17.8[13.6] years), had more females (60.7% vs 54.7%), and filled fewer SABA claims (1.9[1.4] vs 2.5[2.2]) (all p<0.001). A smaller proportion of patients in the EIB(alone) than EIB(asthma) group had maintenance therapy claims (79.9% vs 90.6%, p<0.001). The EIB(alone) group also had a lower proportion of patients with oral or injectable corticosteroid claims (29.4% vs 32.0%) and asthma and/or EIB-related emergency department (1.0% vs 13.0%) or outpatient visits (65.1% vs 72.3%; all p<0.0001). Annual days’ supply of oral corticosteroids was similar between groups (mean[SD] EIB(alone): 20.7[30.8] vs EIB(asthma): 19.8[28] days). CONCLUSION: Individuals with EIB(alone) or EIB(asthma) demonstrate considerable morbidity. New treatment paradigms may be needed to optimize outcomes for both patient groups.