Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care

Hilda J.I. De Jong; David Price; Jaco Voorham; Glenis K Scadding; Claus Bachert; Giorgio Walter Canonica; Peter  Smith; Ulrich Wahn; Dermot Ryan; Jose A. Castillo; Victoria A  Carter; Ruth B Murray; David B Price

doi:10.1016/j.waojou.2020.100490

Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care

Hilda J.I. De Jong, David Price^* (Corresponding Author), Jaco Voorham, Glenis K Scadding, Claus Bachert, Giorgio Walter Canonica, Peter Smith, Ulrich Wahn, Dermot Ryan, Jose A. Castillo, Victoria A Carter, Ruth B Murray, David B Price^* (Corresponding Author)

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: MP-AzeFlu (Dymista®; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown. Methods: This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged ≥ 12 years, from UK general practice with active asthma (defined as a recorded diagnosis, with ≥1 prescription for reliever or controller inhaler) in the year before or at the initiation date. The primary study outcome was change in number of acute respiratory events (i.e. exacerbation or antibiotic course for a respiratory event) between baseline and outcome years. The effect size of MP-AzeFlu was quantified as the difference in % of patients that improved and worsened. Results: Of the 1,188 patients with AR and asthma included, many had a record of irreversible obstruction (67%), and uncontrolled asthma (70.4%), despite high mean daily doses of reliever/controller therapy and acute oral corticosteroid use, in the year pre-MP-AzeFlu initiation. MP-AzeFlu initiation was associated with fewer acute respiratory events (effect size (e)=5.8%, p=0.0129) and a reduction in daily use of short-acting β2-agonists, with fewer patients requiring >2 SABA puffs/week (e=7.7% p<0.0001). More patients had well-controlled asthma 1-year post-MP-AzeFlu initiation (e=4.1%; p=0.0037), despite a reduction in inhaled corticosteroids (e=4.8%; p=0.0078). Conclusions: This study provides the first direct evidence of the beneficial effect of MP-AzeFlu on asthma outcomes in co-morbid patients in primary care in the UK. Trial registration: EUPAS30940. Registered 13 August 2019.

Original language	English
Article number	100490
Number of pages	18
Journal	World Allergy Organization Journal
Volume	13
Issue number	12
Early online date	19 Nov 2020
DOIs	https://doi.org/10.1016/j.waojou.2020.100490
Publication status	Published - Dec 2020

Keywords

control
exacerbations
rescue medication

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De Jong, H. J. I., Price, D., Voorham, J., Scadding, G. K., Bachert, C., Canonica, G. W., Smith, P., Wahn, U., Ryan, D., Castillo, J. A., Carter, V. A., Murray, R. B., & Price, D. B. (2020). Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care. World Allergy Organization Journal, 13(12), [100490]. https://doi.org/10.1016/j.waojou.2020.100490

Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care. / De Jong, Hilda J.I.; Price, David (Corresponding Author); Voorham, Jaco; Scadding, Glenis K; Bachert, Claus; Canonica, Giorgio Walter; Smith, Peter ; Wahn, Ulrich; Ryan, Dermot; Castillo, Jose A.; Carter, Victoria A; Murray, Ruth B; Price, David B (Corresponding Author).

In: World Allergy Organization Journal, Vol. 13, No. 12, 100490, 12.2020.

Research output: Contribution to journal › Article › peer-review

De Jong, HJI, Price, D, Voorham, J, Scadding, GK, Bachert, C, Canonica, GW, Smith, P, Wahn, U, Ryan, D, Castillo, JA, Carter, VA, Murray, RB & Price, DB 2020, 'Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care', World Allergy Organization Journal, vol. 13, no. 12, 100490. https://doi.org/10.1016/j.waojou.2020.100490

De Jong, Hilda J.I. ; Price, David ; Voorham, Jaco ; Scadding, Glenis K ; Bachert, Claus ; Canonica, Giorgio Walter ; Smith, Peter ; Wahn, Ulrich ; Ryan, Dermot ; Castillo, Jose A. ; Carter, Victoria A ; Murray, Ruth B ; Price, David B. / Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care. In: World Allergy Organization Journal. 2020 ; Vol. 13, No. 12.

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title = "Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care",

abstract = "Background: MP-AzeFlu (Dymista{\textregistered}; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown. Methods: This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged ≥ 12 years, from UK general practice with active asthma (defined as a recorded diagnosis, with ≥1 prescription for reliever or controller inhaler) in the year before or at the initiation date. The primary study outcome was change in number of acute respiratory events (i.e. exacerbation or antibiotic course for a respiratory event) between baseline and outcome years. The effect size of MP-AzeFlu was quantified as the difference in % of patients that improved and worsened. Results: Of the 1,188 patients with AR and asthma included, many had a record of irreversible obstruction (67%), and uncontrolled asthma (70.4%), despite high mean daily doses of reliever/controller therapy and acute oral corticosteroid use, in the year pre-MP-AzeFlu initiation. MP-AzeFlu initiation was associated with fewer acute respiratory events (effect size (e)=5.8%, p=0.0129) and a reduction in daily use of short-acting β2-agonists, with fewer patients requiring >2 SABA puffs/week (e=7.7% p<0.0001). More patients had well-controlled asthma 1-year post-MP-AzeFlu initiation (e=4.1%; p=0.0037), despite a reduction in inhaled corticosteroids (e=4.8%; p=0.0078). Conclusions: This study provides the first direct evidence of the beneficial effect of MP-AzeFlu on asthma outcomes in co-morbid patients in primary care in the UK. Trial registration: EUPAS30940. Registered 13 August 2019. ",

keywords = "control, exacerbations, rescue medication",

author = "{De Jong}, {Hilda J.I.} and David Price and Jaco Voorham and Scadding, {Glenis K} and Claus Bachert and Canonica, {Giorgio Walter} and Peter Smith and Ulrich Wahn and Dermot Ryan and Castillo, {Jose A.} and Carter, {Victoria A} and Murray, {Ruth B} and Price, {David B}",

note = "This study was supported by funding from BGP Products Operations GmbH (A MylanCompany). BGP Products Operations GmbH was given the opportunity to review the manuscript for medical and scientific accuracy as well as for intellectual property considerations. The dataset supporting the conclusions of this article was derived from the Optimum Patient Care Research Database (www.opcrd.co.uk). The OPCRD has ethical approval from the National Health Service (NHS) Research Authority to hold and process anonymized research data (Research Ethics Committee reference: 15/EM/0150). This study was approved by the Anonymized Data Ethics Protocols and Transparency (ADEPT) committee – the independent scientific advisory committee for the OPCRD. The authors do not have permission to give public access to the study dataset; researchers may request access to OPCRD data for their own purposes. Access to OCPRD can be made via the OCPRD website (https://opcrd.co.uk/our-database/data-requests/) or via the enquiries email info@opcrd.co.uk.",

year = "2020",

month = dec,

doi = "10.1016/j.waojou.2020.100490",

language = "English",

volume = "13",

journal = "World Allergy Organization Journal",

issn = "1939-4551",

publisher = "Lippincott Williams and Wilkins",

number = "12",

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TY - JOUR

T1 - Evaluating the Real-life Effect of MP-AzeFlu On Asthma Outcomes In Patients With Allergic Rhinitis and Asthma In UK Primary Care

AU - De Jong, Hilda J.I.

AU - Price, David

AU - Voorham, Jaco

AU - Scadding, Glenis K

AU - Bachert, Claus

AU - Canonica, Giorgio Walter

AU - Smith, Peter

AU - Wahn, Ulrich

AU - Ryan, Dermot

AU - Castillo, Jose A.

AU - Carter, Victoria A

AU - Murray, Ruth B

AU - Price, David B

N1 - This study was supported by funding from BGP Products Operations GmbH (A MylanCompany). BGP Products Operations GmbH was given the opportunity to review the manuscript for medical and scientific accuracy as well as for intellectual property considerations. The dataset supporting the conclusions of this article was derived from the Optimum Patient Care Research Database (www.opcrd.co.uk). The OPCRD has ethical approval from the National Health Service (NHS) Research Authority to hold and process anonymized research data (Research Ethics Committee reference: 15/EM/0150). This study was approved by the Anonymized Data Ethics Protocols and Transparency (ADEPT) committee – the independent scientific advisory committee for the OPCRD. The authors do not have permission to give public access to the study dataset; researchers may request access to OPCRD data for their own purposes. Access to OCPRD can be made via the OCPRD website (https://opcrd.co.uk/our-database/data-requests/) or via the enquiries email info@opcrd.co.uk.

PY - 2020/12

Y1 - 2020/12

N2 - Background: MP-AzeFlu (Dymista®; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown. Methods: This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged ≥ 12 years, from UK general practice with active asthma (defined as a recorded diagnosis, with ≥1 prescription for reliever or controller inhaler) in the year before or at the initiation date. The primary study outcome was change in number of acute respiratory events (i.e. exacerbation or antibiotic course for a respiratory event) between baseline and outcome years. The effect size of MP-AzeFlu was quantified as the difference in % of patients that improved and worsened. Results: Of the 1,188 patients with AR and asthma included, many had a record of irreversible obstruction (67%), and uncontrolled asthma (70.4%), despite high mean daily doses of reliever/controller therapy and acute oral corticosteroid use, in the year pre-MP-AzeFlu initiation. MP-AzeFlu initiation was associated with fewer acute respiratory events (effect size (e)=5.8%, p=0.0129) and a reduction in daily use of short-acting β2-agonists, with fewer patients requiring >2 SABA puffs/week (e=7.7% p<0.0001). More patients had well-controlled asthma 1-year post-MP-AzeFlu initiation (e=4.1%; p=0.0037), despite a reduction in inhaled corticosteroids (e=4.8%; p=0.0078). Conclusions: This study provides the first direct evidence of the beneficial effect of MP-AzeFlu on asthma outcomes in co-morbid patients in primary care in the UK. Trial registration: EUPAS30940. Registered 13 August 2019.

AB - Background: MP-AzeFlu (Dymista®; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown. Methods: This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged ≥ 12 years, from UK general practice with active asthma (defined as a recorded diagnosis, with ≥1 prescription for reliever or controller inhaler) in the year before or at the initiation date. The primary study outcome was change in number of acute respiratory events (i.e. exacerbation or antibiotic course for a respiratory event) between baseline and outcome years. The effect size of MP-AzeFlu was quantified as the difference in % of patients that improved and worsened. Results: Of the 1,188 patients with AR and asthma included, many had a record of irreversible obstruction (67%), and uncontrolled asthma (70.4%), despite high mean daily doses of reliever/controller therapy and acute oral corticosteroid use, in the year pre-MP-AzeFlu initiation. MP-AzeFlu initiation was associated with fewer acute respiratory events (effect size (e)=5.8%, p=0.0129) and a reduction in daily use of short-acting β2-agonists, with fewer patients requiring >2 SABA puffs/week (e=7.7% p<0.0001). More patients had well-controlled asthma 1-year post-MP-AzeFlu initiation (e=4.1%; p=0.0037), despite a reduction in inhaled corticosteroids (e=4.8%; p=0.0078). Conclusions: This study provides the first direct evidence of the beneficial effect of MP-AzeFlu on asthma outcomes in co-morbid patients in primary care in the UK. Trial registration: EUPAS30940. Registered 13 August 2019.

KW - control

KW - exacerbations

KW - rescue medication

U2 - 10.1016/j.waojou.2020.100490

DO - 10.1016/j.waojou.2020.100490

M3 - Article

VL - 13

JO - World Allergy Organization Journal

JF - World Allergy Organization Journal

SN - 1939-4551

IS - 12

M1 - 100490

ER -