Dataset Information

The relationship between combination inhaled corticosteroid and long-acting ?-agonist use and severe asthma exacerbations in a diverse population.

ABSTRACT:

Background

Safety concerns surround the use of long-acting ?-agonists (LABAs) for the treatment of asthma, even in combination with inhaled corticosteroids (ICSs) and particularly in high-risk subgroups.

Objective

To estimate the effect of ICS therapy and fixed-dose ICS/LABA combination therapy on severe asthma exacerbations in a racially diverse population.

Methods

ICS and ICS/LABA exposure was estimated from pharmacy data for patients with asthma aged 12 to 56 years who were members of a large health maintenance organization. ICS and ICS/LABA use was estimated for each day of follow-up to create a moving window of exposure. Proportional hazard models were used to assess the relationship between ICS and ICS/LABA combination therapy and severe asthma exacerbations (ie, use of oral corticosteroids, asthma-related emergency department visit, or asthma-related hospitalization).

Results

Among the 1828 patients who met the inclusion criteria, 37% were African American, 46% were treated with ICS therapy alone, and 54% were treated with an ICS/LABA combination. Models assessing the risk of severe asthma exacerbations among individuals using ICS treatment alone and ICS/LABA combination therapy suggested that the overall protective effect was as good or better for ICS/LABA combination therapy when compared with ICS treatment alone (hazard ratio, 0.65 vs 0.72, respectively). Analyses in several subgroups, including African American patients, showed a similar statistically significant protective association for combination therapy.

Conclusion

Treatment with ICS/LABA fixed-dose combination therapy appeared to perform as well as or better than ICS treatment alone in reducing severe asthma exacerbations; this included multiple high-risk subgroups.

SUBMITTER: Wells KE

PROVIDER: S-EPMC3340459 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Publications

The relationship between combination inhaled corticosteroid and long-acting β-agonist use and severe asthma exacerbations in a diverse population.

Wells Karen E KE Peterson Edward L EL Ahmedani Brian K BK Severson Richard K RK Gleason-Comstock Julie J Williams L Keoki LK

The Journal of allergy and clinical immunology 20120126 5

<h4>Background</h4>Safety concerns surround the use of long-acting β-agonists (LABAs) for the treatment of asthma, even in combination with inhaled corticosteroids (ICSs) and particularly in high-risk subgroups.<h4>Objective</h4>To estimate the effect of ICS therapy and fixed-dose ICS/LABA combination therapy on severe asthma exacerbations in a racially diverse population.<h4>Methods</h4>ICS and ICS/LABA exposure was estimated from pharmacy data for patients with asthma aged 12 to 56 years who w ...[more]

PMID: 22281166

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