02579nam a22002897a 4500
170411s20162016 xxu||||| |||| 00| 0 eng d
2312-0541
Ovid MEDLINE(R)
27730200
Add-on LABA in a separate inhaler as asthma step-up therapy versus increased dose of ICS or ICS/LABA combination inhaler.
Erj Open Research. 2(2), 2016 Apr
ERJ open res.. 2(2), 2016 Apr
ERJ open research
2016
FY2016
2017-05-24
Asthma management guidelines recommend adding a long-acting beta<sub>2</sub>-agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a >50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler. Risk-domain asthma control was the primary end-point in comparisons of cohorts matched for asthma severity and control during the baseline year. After 1:2 cohort matching, the increased extrafine ICS versus separate ICS+LABA cohorts included 3232 and 6464 patients, respectively, and the fine-particle ICS/LABA FDC versus separate ICS+LABA cohorts included 7529 and 15 058 patients, respectively (overall mean age 42 years; 61-62% females). Over one outcome year, adjusted OR (95% CI) for achieving asthma control were 1.25 (1.13-1.38) for increased ICS versus separate ICS+LABA and 1.06 (1.05-1.09) for ICS/LABA FDC versus separate ICS+LABA. For patients with asthma, increased dose of extrafine-particle ICS, or add-on LABA via ICS/LABA combination inhaler, is associated with significantly better outcomes than ICS+LABA via separate inhalers.
English
PubMed-not-MEDLINE -- Not indexed
MedStar Washington Hospital Center
Medicine/Pulmonary-Critical Care
Journal Article
Colice, Gene L
Colice G, Grigg J, Guilbert TW, Hillyer EV, Israel E, Martin RJ, Postma DS, Price DB, Roche N, Thomas V, van Aalderen WM
https://dx.doi.org/10.1183/23120541.00106-2015
https://dx.doi.org/10.1183/23120541.00106-2015
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authcat
authcat
2017-05-24
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27730200
27730200
2017-05-24
2017-05-24
ART
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2267