Clinical characteristics, treatment patterns, disease burden, and persistence/adherence in patients with asthma initiating inhaled triple therapy: real-world evidence from Japan

Abstract

Objectives

To help optimize triple therapy use, treatment patterns and disease burden were investigated in patients in Japan with persistent asthma who initiated multi-inhaler triple therapy (inhaled corticosteroid/long-acting β₂-agonist/long-acting muscarinic antagonist; ICS/LABA/LAMA).

Methods

This retrospective, observational cohort study using health insurance claims data included adults with persistent asthma who initiated triple therapy in 2016. Patients who were prescribed ICS/LABA in 2016 were included as an ICS/LABA-matched cohort. Patients were stratified into those with asthma only and those with asthma and chronic obstructive pulmonary disease (COPD) codes (asthma-COPD overlap [ACO]). Patient data from 1-year prior to 1 year post index date were analyzed.

Results

For patients with asthma only in the triple therapy and ICS/LABA cohorts, baseline demographics were similar. A higher proportion of the triple-therapy cohort than the ICS/LABA cohort was receiving high-dose ICS at index (68.2% and 27.6%, respectively), and had experienced an exacerbation in the last year (64.0% and 29.4%, respectively). The proportion of patients with asthma only who developed any exacerbation was lower in the year following initiation of triple therapy compared with the year prior to initiation of triple therapy (45.8% vs 64.0%, respectively). For asthma only patients receiving triple therapy, the mean (standard deviation) proportion of days covered and medication possession ratio was 0.51 (0.36) and 0.86 (0.16), respectively. Similar trends were seen in patients with ACO in the triple-therapy and ICS/LABA cohorts.

Conclusion

Evidence from this study may serve as a reference for the use of inhaled triple therapy for asthma.

Keywords:

• Asthma
• bronchodilator agents
• glucocorticoids
• muscarinic antagonists
• metered dose inhalers
• dry powder inhalers
• chronic obstructive pulmonary disease

Transparency

Declaration of funding

The work presented here, including the conduct, conception and design of the study, data analysis and interpretation, was funded by GlaxoSmithKline (GSK) (GSK study ID: HO-18-18524). The sponsor was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations.

Declaration of financial/other relationships

The authors met the criteria for authorship as recommended by the International Committee of Medical Journal Editors. All authors are employees of GSK and JFB, KS and TK own stock in GSK. TK is a part-time employee of Shiga University of Medical Science. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Adoair, Diskus, Ellipta, Relvar and Sultanol are owned by or licensed to the GSK group of companies. Airomir is a trademark of Teva Pharmaceuticals International. Berotec is a trademark of Boehringer Ingelheim. Clickhaler is a trademark of M L Laboratories PLC. Flutiform is a trademark of Jagotec AG. Meptin and Swinghaler are trademarks of Otsuka Pharmaceutical Co., Ltd. Stmerin D is a trademark of Astellas Pharma Inc. Symbicort is a trademark of AstraZeneca AB.

Author contributions

All authors were involved in the conception and design of the study, the data analysis and interpretation, and writing and reviewing of the manuscript, and have given final approval to the version to be published.

Acknowledgements

Editorial support in the form of initial preparation of the outline based on input from all authors, and collation and incorporation of author feedback to develop subsequent drafts, assembling tables and figures, copyediting, and referencing was provided by Chloe Stevenson, MSci, of Fishawack Indicia Ltd, UK, and was funded by GSK.

Data availability

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