哮喘患者ICS/LAMA/LABA依从性分析：一项使用医疗索赔数据的回顾性观察队列研究

IF 2.4 Q2 RESPIRATORY SYSTEM

Respiratory investigation Pub Date : 2025-05-05 DOI:10.1016/j.resinv.2025.04.017

Toru Oga , Risako Ito , Chifuku Mita , Masashi Takano , Gema Requena , Isao Mukai , Masao Yarita

{"title":"哮喘患者ICS/LAMA/LABA依从性分析：一项使用医疗索赔数据的回顾性观察队列研究","authors":"Toru Oga , Risako Ito , Chifuku Mita , Masashi Takano , Gema Requena , Isao Mukai , Masao Yarita","doi":"10.1016/j.resinv.2025.04.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Real-world evidence of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) use in Japan is limited. This real-world study assessed adherence to FF/UMEC/VI once-daily single-inhaler triple therapy (SITT) versus multiple-inhaler triple therapy (MITT) among patients with asthma in Japan.</div></div><div><h3>Methods</h3><div>Retrospective observational cohort study of patients with asthma initiating FF/UMEC/VI SITT or MITT, using claims data (02/18/2021-02/28/2022, JMDC database). Patients were aged ≥15 years at index (date of FF/UMEC/VI or MITT claim). Outcomes were assessed in two cohorts and weighted using inverse probability of treatment weighting: 1) ‘overall cohort’ included patients who received FF/UMEC/VI or MITT as initial maintenance therapy (IMT) or as non-IMT (i.e., had previously received inhaled corticosteroid-containing medication during baseline); 2) ‘non-IMT cohort’ was a sub-cohort of the overall cohort. Primary outcome: proportion of adherent patients (proportion of days covered ≥0.8) in the 3, 6, and 12 months after, and including, index date.</div></div><div><h3>Results</h3><div>The overall cohort comprised 7228 (FF/UMEC/VI) and 864 (MITT) patients. Of these, 3623 and 735 were included in the FF/UMEC/VI and MITT non-IMT cohort, respectively. At 3 months post-index, a significantly higher proportion of patients were adherent to FF/UMEC/VI (36.4 % [n = 2631]) versus MITT (31.2 % [n = 270]) in the overall cohort (rate ratio [95 % confidence interval], 1.16 [1.05–1.29], p = 0.003, weighted), and FF/UMEC/VI (36.6 % [n = 1326]) versus MITT (28.9 % [n = 213]) in the non-IMT cohort (1.26 [1.12–1.43], p < 0.001). Similar results were observed at 6, and 12 months post-index.</div></div><div><h3>Conclusions</h3><div>Patients with asthma in Japan who initiated FF/UMEC/VI SITT had significantly better treatment adherence than those who initiated MITT.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 569-575"},"PeriodicalIF":2.4000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of adherence to ICS/LAMA/LABA in patients with asthma: a retrospective observational cohort study using medical claims data\",\"authors\":\"Toru Oga , Risako Ito , Chifuku Mita , Masashi Takano , Gema Requena , Isao Mukai , Masao Yarita\",\"doi\":\"10.1016/j.resinv.2025.04.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Real-world evidence of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) use in Japan is limited. This real-world study assessed adherence to FF/UMEC/VI once-daily single-inhaler triple therapy (SITT) versus multiple-inhaler triple therapy (MITT) among patients with asthma in Japan.</div></div><div><h3>Methods</h3><div>Retrospective observational cohort study of patients with asthma initiating FF/UMEC/VI SITT or MITT, using claims data (02/18/2021-02/28/2022, JMDC database). Patients were aged ≥15 years at index (date of FF/UMEC/VI or MITT claim). Outcomes were assessed in two cohorts and weighted using inverse probability of treatment weighting: 1) ‘overall cohort’ included patients who received FF/UMEC/VI or MITT as initial maintenance therapy (IMT) or as non-IMT (i.e., had previously received inhaled corticosteroid-containing medication during baseline); 2) ‘non-IMT cohort’ was a sub-cohort of the overall cohort. Primary outcome: proportion of adherent patients (proportion of days covered ≥0.8) in the 3, 6, and 12 months after, and including, index date.</div></div><div><h3>Results</h3><div>The overall cohort comprised 7228 (FF/UMEC/VI) and 864 (MITT) patients. Of these, 3623 and 735 were included in the FF/UMEC/VI and MITT non-IMT cohort, respectively. At 3 months post-index, a significantly higher proportion of patients were adherent to FF/UMEC/VI (36.4 % [n = 2631]) versus MITT (31.2 % [n = 270]) in the overall cohort (rate ratio [95 % confidence interval], 1.16 [1.05–1.29], p = 0.003, weighted), and FF/UMEC/VI (36.6 % [n = 1326]) versus MITT (28.9 % [n = 213]) in the non-IMT cohort (1.26 [1.12–1.43], p < 0.001). Similar results were observed at 6, and 12 months post-index.</div></div><div><h3>Conclusions</h3><div>Patients with asthma in Japan who initiated FF/UMEC/VI SITT had significantly better treatment adherence than those who initiated MITT.</div></div>\",\"PeriodicalId\":20934,\"journal\":{\"name\":\"Respiratory investigation\",\"volume\":\"63 4\",\"pages\":\"Pages 569-575\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-05-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory investigation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212534525000590\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory investigation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212534525000590","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

摘要

在现实世界中，糠酸氟替卡松/乌莫利维/维兰特罗（FF/UMEC/VI）在日本的使用证据有限。这项真实世界的研究评估了日本哮喘患者每日一次的FF/UMEC/VI单吸入器三联疗法（SITT）与多吸入器三联疗法（MITT）的依从性。方法回顾性观察队列研究初始FF/UMEC/VI SITT或MITT哮喘患者，使用索赔数据（2021年2月18日- 2022年2月28日，JMDC数据库）。患者在指标（FF/UMEC/VI或MITT索赔日期）时年龄≥15岁。结果分为两个队列进行评估，并使用治疗加权逆概率进行加权：1)“整体队列”包括接受FF/UMEC/VI或MITT作为初始维持治疗（IMT）或非IMT（即先前在基线期间接受吸入含皮质类固醇药物）的患者；2)“非imt队列”是整个队列的一个子队列。主要结局：指标日期后3、6和12个月（覆盖天数比例≥0.8天）的患者比例。结果整个队列包括7228例FF/UMEC/VI患者和864例MITT患者。其中，3623人和735人分别被纳入FF/UMEC/VI和MITT非imt队列。指数后3个月，在整个队列中，FF/UMEC/VI的患者比例（36.4% [n = 2631]）明显高于MITT (31.2% [n = 270])（比率比[95%可信区间]，1.16 [1.05-1.29],p = 0.003，加权），非imt队列中FF/UMEC/VI （36.6% [n = 1326]）比MITT (28.9% [n = 213]) (1.26 [1.12-1.43], p <；0.001)。在6个月和12个月后观察到类似的结果。结论日本哮喘患者FF/UMEC/VI SITT治疗依从性明显优于MITT治疗依从性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Analysis of adherence to ICS/LAMA/LABA in patients with asthma: a retrospective observational cohort study using medical claims data

Background

Real-world evidence of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) use in Japan is limited. This real-world study assessed adherence to FF/UMEC/VI once-daily single-inhaler triple therapy (SITT) versus multiple-inhaler triple therapy (MITT) among patients with asthma in Japan.

Methods

Retrospective observational cohort study of patients with asthma initiating FF/UMEC/VI SITT or MITT, using claims data (02/18/2021-02/28/2022, JMDC database). Patients were aged ≥15 years at index (date of FF/UMEC/VI or MITT claim). Outcomes were assessed in two cohorts and weighted using inverse probability of treatment weighting: 1) ‘overall cohort’ included patients who received FF/UMEC/VI or MITT as initial maintenance therapy (IMT) or as non-IMT (i.e., had previously received inhaled corticosteroid-containing medication during baseline); 2) ‘non-IMT cohort’ was a sub-cohort of the overall cohort. Primary outcome: proportion of adherent patients (proportion of days covered ≥0.8) in the 3, 6, and 12 months after, and including, index date.

Results

The overall cohort comprised 7228 (FF/UMEC/VI) and 864 (MITT) patients. Of these, 3623 and 735 were included in the FF/UMEC/VI and MITT non-IMT cohort, respectively. At 3 months post-index, a significantly higher proportion of patients were adherent to FF/UMEC/VI (36.4 % [n = 2631]) versus MITT (31.2 % [n = 270]) in the overall cohort (rate ratio [95 % confidence interval], 1.16 [1.05–1.29], p = 0.003, weighted), and FF/UMEC/VI (36.6 % [n = 1326]) versus MITT (28.9 % [n = 213]) in the non-IMT cohort (1.26 [1.12–1.43], p < 0.001). Similar results were observed at 6, and 12 months post-index.