Real-life comparison of beclometasone dipropionate as an extrafine- or larger-particle formulation for asthma

David Price, Mike Thomas, John Haughney, Richard A Lewis, Anne Burden, Julie von Ziegenweidt, Alison Chisholm, Elizabeth V Hillyer, Christopher J Corrigan

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

BACKGROUND: Beclometasone dipropionate is an inhaled corticosteroid (ICS) available in both extrafine and larger-particle hydrofluoroalkane formulations. Extrafine beclometasone has greater small airway distribution and inhalation technique tolerance than larger-particle beclometasone; therefore, its use may be associated with improved asthma outcomes at population levels. The study objective was to compare real-life effectiveness of extrafine and larger-particle beclometasone.

METHODS: Retrospective matched cohort study including primary care patients with asthma (ages 12-60 and non-smokers 61-80 years) prescribed extrafine or larger-particle beclometasone by metered-dose inhaler. We studied patients receiving their first ICS (initiation population, n = 11,289) or switched from another ICS without dose change (switch population, n = 19,065). The extrafine and larger-particle beclometasone cohorts were matched in each population for demographic and database measures of asthma control during a baseline year; and endpoints assessed during 1 outcome year were adjusted for residual confounding factors.

RESULTS: The odds of no loss of asthma control (no asthma-related hospital attendance, consultation for lower respiratory tract infection, or oral corticosteroids) were significantly higher in the extrafine beclometasone cohorts of both initiation population (adjusted odds ratio [aOR] 1.12; 95% CI 1.02-1.23) and switch population (aOR 1.10; 95% CI 1.01-1.19). The odds of better adherence to ICS therapy were also significantly higher in both extrafine beclometasone cohorts (initiation population, aOR 1.64; 95% CI 1.52-1.75 and switch population, aOR 1.35; 95% CI 1.27-1.43).

CONCLUSIONS: These findings are consistent with the hypothesis that delivery of beclometasone in extrafine particle size produces real-life asthma treatment benefits. Clinical trials no. NCT01400217.

Original languageEnglish
Pages (from-to)987-1000
Number of pages14
JournalRespiratory Medicine
Volume107
Issue number7
Early online date3 May 2013
DOIs
Publication statusPublished - Jul 2013

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Beclomethasone
Asthma
Adrenal Cortex Hormones
Population
Odds Ratio
HFA 134a
Metered Dose Inhalers
Particle Size
Respiratory Tract Infections
Inhalation
Primary Health Care
Cohort Studies
Referral and Consultation
Demography
Clinical Trials
Databases

Keywords

  • Administration, Inhalation
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Asthmatic Agents
  • Asthma
  • Beclomethasone
  • Chemistry, Pharmaceutical
  • Child
  • Drug Administration Schedule
  • Female
  • Glucocorticoids
  • Humans
  • Male
  • Medication Adherence
  • Metered Dose Inhalers
  • Middle Aged
  • Particle Size
  • Primary Health Care
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Cite this

Real-life comparison of beclometasone dipropionate as an extrafine- or larger-particle formulation for asthma. / Price, David; Thomas, Mike; Haughney, John; Lewis, Richard A; Burden, Anne; von Ziegenweidt, Julie; Chisholm, Alison; Hillyer, Elizabeth V; Corrigan, Christopher J.

In: Respiratory Medicine, Vol. 107, No. 7, 07.2013, p. 987-1000.

Research output: Contribution to journalArticle

Price, D, Thomas, M, Haughney, J, Lewis, RA, Burden, A, von Ziegenweidt, J, Chisholm, A, Hillyer, EV & Corrigan, CJ 2013, 'Real-life comparison of beclometasone dipropionate as an extrafine- or larger-particle formulation for asthma', Respiratory Medicine, vol. 107, no. 7, pp. 987-1000. https://doi.org/10.1016/j.rmed.2013.03.009
Price, David ; Thomas, Mike ; Haughney, John ; Lewis, Richard A ; Burden, Anne ; von Ziegenweidt, Julie ; Chisholm, Alison ; Hillyer, Elizabeth V ; Corrigan, Christopher J. / Real-life comparison of beclometasone dipropionate as an extrafine- or larger-particle formulation for asthma. In: Respiratory Medicine. 2013 ; Vol. 107, No. 7. pp. 987-1000.
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abstract = "BACKGROUND: Beclometasone dipropionate is an inhaled corticosteroid (ICS) available in both extrafine and larger-particle hydrofluoroalkane formulations. Extrafine beclometasone has greater small airway distribution and inhalation technique tolerance than larger-particle beclometasone; therefore, its use may be associated with improved asthma outcomes at population levels. The study objective was to compare real-life effectiveness of extrafine and larger-particle beclometasone.METHODS: Retrospective matched cohort study including primary care patients with asthma (ages 12-60 and non-smokers 61-80 years) prescribed extrafine or larger-particle beclometasone by metered-dose inhaler. We studied patients receiving their first ICS (initiation population, n = 11,289) or switched from another ICS without dose change (switch population, n = 19,065). The extrafine and larger-particle beclometasone cohorts were matched in each population for demographic and database measures of asthma control during a baseline year; and endpoints assessed during 1 outcome year were adjusted for residual confounding factors.RESULTS: The odds of no loss of asthma control (no asthma-related hospital attendance, consultation for lower respiratory tract infection, or oral corticosteroids) were significantly higher in the extrafine beclometasone cohorts of both initiation population (adjusted odds ratio [aOR] 1.12; 95{\%} CI 1.02-1.23) and switch population (aOR 1.10; 95{\%} CI 1.01-1.19). The odds of better adherence to ICS therapy were also significantly higher in both extrafine beclometasone cohorts (initiation population, aOR 1.64; 95{\%} CI 1.52-1.75 and switch population, aOR 1.35; 95{\%} CI 1.27-1.43).CONCLUSIONS: These findings are consistent with the hypothesis that delivery of beclometasone in extrafine particle size produces real-life asthma treatment benefits. Clinical trials no. NCT01400217.",
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AU - Price, David

AU - Thomas, Mike

AU - Haughney, John

AU - Lewis, Richard A

AU - Burden, Anne

AU - von Ziegenweidt, Julie

AU - Chisholm, Alison

AU - Hillyer, Elizabeth V

AU - Corrigan, Christopher J

N1 - Copyright © 2013 Elsevier Ltd. All rights reserved.

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N2 - BACKGROUND: Beclometasone dipropionate is an inhaled corticosteroid (ICS) available in both extrafine and larger-particle hydrofluoroalkane formulations. Extrafine beclometasone has greater small airway distribution and inhalation technique tolerance than larger-particle beclometasone; therefore, its use may be associated with improved asthma outcomes at population levels. The study objective was to compare real-life effectiveness of extrafine and larger-particle beclometasone.METHODS: Retrospective matched cohort study including primary care patients with asthma (ages 12-60 and non-smokers 61-80 years) prescribed extrafine or larger-particle beclometasone by metered-dose inhaler. We studied patients receiving their first ICS (initiation population, n = 11,289) or switched from another ICS without dose change (switch population, n = 19,065). The extrafine and larger-particle beclometasone cohorts were matched in each population for demographic and database measures of asthma control during a baseline year; and endpoints assessed during 1 outcome year were adjusted for residual confounding factors.RESULTS: The odds of no loss of asthma control (no asthma-related hospital attendance, consultation for lower respiratory tract infection, or oral corticosteroids) were significantly higher in the extrafine beclometasone cohorts of both initiation population (adjusted odds ratio [aOR] 1.12; 95% CI 1.02-1.23) and switch population (aOR 1.10; 95% CI 1.01-1.19). The odds of better adherence to ICS therapy were also significantly higher in both extrafine beclometasone cohorts (initiation population, aOR 1.64; 95% CI 1.52-1.75 and switch population, aOR 1.35; 95% CI 1.27-1.43).CONCLUSIONS: These findings are consistent with the hypothesis that delivery of beclometasone in extrafine particle size produces real-life asthma treatment benefits. Clinical trials no. NCT01400217.

AB - BACKGROUND: Beclometasone dipropionate is an inhaled corticosteroid (ICS) available in both extrafine and larger-particle hydrofluoroalkane formulations. Extrafine beclometasone has greater small airway distribution and inhalation technique tolerance than larger-particle beclometasone; therefore, its use may be associated with improved asthma outcomes at population levels. The study objective was to compare real-life effectiveness of extrafine and larger-particle beclometasone.METHODS: Retrospective matched cohort study including primary care patients with asthma (ages 12-60 and non-smokers 61-80 years) prescribed extrafine or larger-particle beclometasone by metered-dose inhaler. We studied patients receiving their first ICS (initiation population, n = 11,289) or switched from another ICS without dose change (switch population, n = 19,065). The extrafine and larger-particle beclometasone cohorts were matched in each population for demographic and database measures of asthma control during a baseline year; and endpoints assessed during 1 outcome year were adjusted for residual confounding factors.RESULTS: The odds of no loss of asthma control (no asthma-related hospital attendance, consultation for lower respiratory tract infection, or oral corticosteroids) were significantly higher in the extrafine beclometasone cohorts of both initiation population (adjusted odds ratio [aOR] 1.12; 95% CI 1.02-1.23) and switch population (aOR 1.10; 95% CI 1.01-1.19). The odds of better adherence to ICS therapy were also significantly higher in both extrafine beclometasone cohorts (initiation population, aOR 1.64; 95% CI 1.52-1.75 and switch population, aOR 1.35; 95% CI 1.27-1.43).CONCLUSIONS: These findings are consistent with the hypothesis that delivery of beclometasone in extrafine particle size produces real-life asthma treatment benefits. Clinical trials no. NCT01400217.

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