Effects of short- and long-acting beta-agonists on asthma exacerbations: a prospective cohort

ASTRO-LAB group

doi:10.1016/j.anai.2019.12.012

Effects of short- and long-acting beta-agonists on asthma exacerbations: a prospective cohort

ASTRO-LAB group

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Abstract

BACKGROUND: In asthma, short- and long-acting β-agonists (SABAs and LABAs) should be used together with inhaled corticosteroids (ICS), and regular use is inappropriate.

OBJECTIVE: To assess the relationship between patterns of use of therapy and asthma exacerbations (AEx).

METHODS: Patients with asthma (6-40 years) were enrolled in France and the United Kingdom. Prescribing data, computer-assisted telephone interviews (CATIs), and text messages assessed medication use and AEx over a maximum period of 24 months. Generalized linear mixed models provided AEx risks associated with therapy.

RESULTS: Among the 908 patients (median age: 20.0 years, 46.6% women, 24.5% children) answering a total of 4248 CATIs over 486 (±235) days, regular (ie, daily) use was more frequent for single LABAs and fixed dose combinations (FDCs) than for single ICS (75.6%, 70.1%, and 65.4% of investigated periods of use, respectively). Regular (ie, daily or almost daily) SABA use was observed for 21.1% of periods of use. Altogether, 265 patients (29.2%) experienced 1 or more AEx. The ORs for AEx risk related to regular vs no use of FDCs, single ICS, and single LABAs were 0.98 (95% CI = [0.73-1.33]), 0.90 (95% CI = [0.61-1.33]), and 1.29 (95% CI = [0.76-2.17]), respectively, after adjustment for cotherapy, sociodemographic, and disease characteristics. The OR was 2.09 (95% CI = [1.36-3.21]) in regular SABA users.

CONCLUSION: Inhaled corticosteroids and FDCs were often used intermittently, whereas SABAs and LABAs could be used regularly, and exacerbations were frequent. Compared with non-users, the risk of exacerbation increased moderately under regular use of single LABAs, whereas it doubled, significantly, in regular SABA users, likely in relationship with poor overall asthma control.

Original language	English
Pages (from-to)	254-260
Number of pages	7
Journal	Annals of Allergy, Asthma, and Immunology
Volume	124
Issue number	3
Early online date	17 Dec 2019
DOIs	https://doi.org/10.1016/j.anai.2019.12.012
Publication status	Published - Mar 2020

Bibliographical note

Funding Sources: The study was funded by the European Commission through the Seventh Framework Program (FP7-Grant Agreement n° 282 593) and gathered 7 partners in a consortium: Claude Bernard Lyon 1 University, University of Nottingham, Kappa Santé SAS, IMS Health, University of Amsterdam, Consortio Mar Parc de Salut de Barcelona and Lyon Ingénierie Projets. The study has been registered in the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) Registry under reference number ENCEPP/SDPP/3099.

Keywords

ADDING SALMETEROL
ADHERENCE
COMBINATION
CHILDREN
RISK

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Cite this

@article{34b0f09aa8ee43de9dc819a9a3604f7f,

title = "Effects of short- and long-acting beta-agonists on asthma exacerbations: a prospective cohort",

abstract = "BACKGROUND: In asthma, short- and long-acting β-agonists (SABAs and LABAs) should be used together with inhaled corticosteroids (ICS), and regular use is inappropriate.OBJECTIVE: To assess the relationship between patterns of use of therapy and asthma exacerbations (AEx).METHODS: Patients with asthma (6-40 years) were enrolled in France and the United Kingdom. Prescribing data, computer-assisted telephone interviews (CATIs), and text messages assessed medication use and AEx over a maximum period of 24 months. Generalized linear mixed models provided AEx risks associated with therapy.RESULTS: Among the 908 patients (median age: 20.0 years, 46.6% women, 24.5% children) answering a total of 4248 CATIs over 486 (±235) days, regular (ie, daily) use was more frequent for single LABAs and fixed dose combinations (FDCs) than for single ICS (75.6%, 70.1%, and 65.4% of investigated periods of use, respectively). Regular (ie, daily or almost daily) SABA use was observed for 21.1% of periods of use. Altogether, 265 patients (29.2%) experienced 1 or more AEx. The ORs for AEx risk related to regular vs no use of FDCs, single ICS, and single LABAs were 0.98 (95% CI = [0.73-1.33]), 0.90 (95% CI = [0.61-1.33]), and 1.29 (95% CI = [0.76-2.17]), respectively, after adjustment for cotherapy, sociodemographic, and disease characteristics. The OR was 2.09 (95% CI = [1.36-3.21]) in regular SABA users.CONCLUSION: Inhaled corticosteroids and FDCs were often used intermittently, whereas SABAs and LABAs could be used regularly, and exacerbations were frequent. Compared with non-users, the risk of exacerbation increased moderately under regular use of single LABAs, whereas it doubled, significantly, in regular SABA users, likely in relationship with poor overall asthma control.",

keywords = "ADDING SALMETEROL, ADHERENCE, COMBINATION, CHILDREN, RISK",

author = "{Van Ganse}, Eric and Nathalie Texier and Dima, {Alexandra L} and Manon Belhassen and Laurent Laforest and Sandrine Herbage and St{\'e}phane Schuck and Gimena Hernandez and Olatz Garin and Montse Ferrer and {de Bruin}, Marijn and {ASTRO-LAB group}",

note = "Funding Sources: The study was funded by the European Commission through the Seventh Framework Program (FP7-Grant Agreement n° 282 593) and gathered 7 partners in a consortium: Claude Bernard Lyon 1 University, University of Nottingham, Kappa Sant{\'e} SAS, IMS Health, University of Amsterdam, Consortio Mar Parc de Salut de Barcelona and Lyon Ing{\'e}nierie Projets. The study has been registered in the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) Registry under reference number ENCEPP/SDPP/3099.",

year = "2020",

month = mar,

doi = "10.1016/j.anai.2019.12.012",

language = "English",

volume = "124",

pages = "254--260",

journal = "Annals of Allergy, Asthma, and Immunology",

issn = "1081-1206",

publisher = "Elsevier",

number = "3",

}

TY - JOUR

T1 - Effects of short- and long-acting beta-agonists on asthma exacerbations

T2 - a prospective cohort

AU - Van Ganse, Eric

AU - Texier, Nathalie

AU - Dima, Alexandra L

AU - Belhassen, Manon

AU - Laforest, Laurent

AU - Herbage, Sandrine

AU - Schuck, Stéphane

AU - Hernandez, Gimena

AU - Garin, Olatz

AU - Ferrer, Montse

AU - de Bruin, Marijn

AU - ASTRO-LAB group

N1 - Funding Sources: The study was funded by the European Commission through the Seventh Framework Program (FP7-Grant Agreement n° 282 593) and gathered 7 partners in a consortium: Claude Bernard Lyon 1 University, University of Nottingham, Kappa Santé SAS, IMS Health, University of Amsterdam, Consortio Mar Parc de Salut de Barcelona and Lyon Ingénierie Projets. The study has been registered in the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) Registry under reference number ENCEPP/SDPP/3099.

PY - 2020/3

Y1 - 2020/3

N2 - BACKGROUND: In asthma, short- and long-acting β-agonists (SABAs and LABAs) should be used together with inhaled corticosteroids (ICS), and regular use is inappropriate.OBJECTIVE: To assess the relationship between patterns of use of therapy and asthma exacerbations (AEx).METHODS: Patients with asthma (6-40 years) were enrolled in France and the United Kingdom. Prescribing data, computer-assisted telephone interviews (CATIs), and text messages assessed medication use and AEx over a maximum period of 24 months. Generalized linear mixed models provided AEx risks associated with therapy.RESULTS: Among the 908 patients (median age: 20.0 years, 46.6% women, 24.5% children) answering a total of 4248 CATIs over 486 (±235) days, regular (ie, daily) use was more frequent for single LABAs and fixed dose combinations (FDCs) than for single ICS (75.6%, 70.1%, and 65.4% of investigated periods of use, respectively). Regular (ie, daily or almost daily) SABA use was observed for 21.1% of periods of use. Altogether, 265 patients (29.2%) experienced 1 or more AEx. The ORs for AEx risk related to regular vs no use of FDCs, single ICS, and single LABAs were 0.98 (95% CI = [0.73-1.33]), 0.90 (95% CI = [0.61-1.33]), and 1.29 (95% CI = [0.76-2.17]), respectively, after adjustment for cotherapy, sociodemographic, and disease characteristics. The OR was 2.09 (95% CI = [1.36-3.21]) in regular SABA users.CONCLUSION: Inhaled corticosteroids and FDCs were often used intermittently, whereas SABAs and LABAs could be used regularly, and exacerbations were frequent. Compared with non-users, the risk of exacerbation increased moderately under regular use of single LABAs, whereas it doubled, significantly, in regular SABA users, likely in relationship with poor overall asthma control.

AB - BACKGROUND: In asthma, short- and long-acting β-agonists (SABAs and LABAs) should be used together with inhaled corticosteroids (ICS), and regular use is inappropriate.OBJECTIVE: To assess the relationship between patterns of use of therapy and asthma exacerbations (AEx).METHODS: Patients with asthma (6-40 years) were enrolled in France and the United Kingdom. Prescribing data, computer-assisted telephone interviews (CATIs), and text messages assessed medication use and AEx over a maximum period of 24 months. Generalized linear mixed models provided AEx risks associated with therapy.RESULTS: Among the 908 patients (median age: 20.0 years, 46.6% women, 24.5% children) answering a total of 4248 CATIs over 486 (±235) days, regular (ie, daily) use was more frequent for single LABAs and fixed dose combinations (FDCs) than for single ICS (75.6%, 70.1%, and 65.4% of investigated periods of use, respectively). Regular (ie, daily or almost daily) SABA use was observed for 21.1% of periods of use. Altogether, 265 patients (29.2%) experienced 1 or more AEx. The ORs for AEx risk related to regular vs no use of FDCs, single ICS, and single LABAs were 0.98 (95% CI = [0.73-1.33]), 0.90 (95% CI = [0.61-1.33]), and 1.29 (95% CI = [0.76-2.17]), respectively, after adjustment for cotherapy, sociodemographic, and disease characteristics. The OR was 2.09 (95% CI = [1.36-3.21]) in regular SABA users.CONCLUSION: Inhaled corticosteroids and FDCs were often used intermittently, whereas SABAs and LABAs could be used regularly, and exacerbations were frequent. Compared with non-users, the risk of exacerbation increased moderately under regular use of single LABAs, whereas it doubled, significantly, in regular SABA users, likely in relationship with poor overall asthma control.

KW - ADDING SALMETEROL

KW - ADHERENCE

KW - COMBINATION

KW - CHILDREN

KW - RISK

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U2 - 10.1016/j.anai.2019.12.012

DO - 10.1016/j.anai.2019.12.012

M3 - Article

C2 - 31862434

SN - 1081-1206

VL - 124

SP - 254

EP - 260

JO - Annals of Allergy, Asthma, and Immunology

JF - Annals of Allergy, Asthma, and Immunology

IS - 3

ER -

Effects of short- and long-acting beta-agonists on asthma exacerbations: a prospective cohort

Abstract

Bibliographical note

Keywords

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