Incidence of Exacerbations and Hospitalizations Is Reduced and Time to Exacerbations Is Prolonged with Mometasone Furoate Dry Powder Inhaler Versus Beclomethasone Dipropionate Hydrofluoroalkane Aerosol in Patients with Mild Asthma

Prakash Navaratnam RPh, MPH, PhD , Eduardo Urdaneta MD , John McLaughlin MSPH , Howard S. Friedman PhD, MMS
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引用次数: 1

Abstract

Objective

To compare the incidence and time to onset of exacerbations among mild asthmatic non-controller-naive patients who began treatment with mometasone furoate via a dry powder inhaler (MF-DPI) or a beclomethasone dipropionate-hydrofluoroalkane (BDP-HFA) aerosol inhaler.

Study Design

An administrative claims database was retrospectively examined from January 1, 2005 through June 30, 2008. Patients with mild asthma aged 12-65 years who were US residents and enrolled in their health plan for ≥1 year before and after the index date for MF-DPI or BDP-HFA treatment initiation were included (n = 1273 matched patients per cohort). Primary evaluations included the incidence of and time to any asthma exacerbations and several asthma exacerbation subtypes. Multivariate generalized linear regression modeling analyses were used to compare the postindex incidence of exacerbations between cohorts. Cox regression analyses were conducted to control for the impact of input variables and evaluate the time to exacerbations.

Results

Significantly fewer MF-DPI patients experienced an exacerbation compared with BDP-HFA patients (9.7% vs 11.5%, respectively; P = .0002). At all time points examined, fewer MF-DPI patients compared with BDP-HFA patients experienced any exacerbation or an exacerbation requiring inpatient hospitalization. The difference between cohorts in the incidence of inpatient exacerbations increased over time. MF-DPI patients experienced prolonged time to any asthma exacerbation (hazard ratio = 0.77; P = .0414) or exacerbations requiring inpatient hospitalization (hazard ratio = 0.51; P = .0191) compared with BDP-HFA patients.

Conclusion

These analyses suggest that patients (previously receiving asthma-related therapy) with mild asthma receiving MF-DPI are at lower risk for asthma exacerbations compared with those receiving BDP-HFA.

轻度哮喘患者糠酸莫米松干粉吸入器与二丙酸倍氯米松氢氟烷烃气雾剂的急性发作和住院发生率降低,急性发作时间延长
目的比较经干粉吸入器(MF-DPI)或双丙酸倍氯米松-氢氟烷烃(BDP-HFA)气溶胶吸入器开始使用糠酸莫米松治疗的轻度哮喘非控制者患者的急性发作发生率和发作时间。研究设计对2005年1月1日至2008年6月30日的行政索赔数据库进行回顾性检查。纳入在MF-DPI或BDP-HFA治疗起始指标日期前后参加健康计划≥1年的12-65岁美国居民轻度哮喘患者(每个队列n = 1273名匹配患者)。初步评估包括任何哮喘加重和几种哮喘加重亚型的发生率和时间。采用多元广义线性回归模型分析比较各队列间指数后加重发生率。进行Cox回归分析以控制输入变量的影响并评估到恶化的时间。结果:与BDP-HFA患者相比,MF-DPI患者的病情加重明显减少(分别为9.7%和11.5%;p = 0.0002)。在所有检查的时间点,与BDP-HFA患者相比,MF-DPI患者出现任何恶化或需要住院治疗的恶化。随着时间的推移,住院患者病情恶化发生率在队列之间的差异越来越大。MF-DPI患者哮喘发作时间延长(风险比= 0.77;P = 0.0414)或病情加重需要住院治疗(风险比= 0.51;P = 0.0191),与BDP-HFA患者相比。结论这些分析表明,与接受BDP-HFA治疗的患者相比,接受MF-DPI治疗的轻度哮喘患者哮喘加重的风险较低。
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