Non-interventional study of the safety and effectiveness of fluticasone propionate/formoterol fumarate in real-world asthma management

. 2018 Jan-Dec ; 12 () : 1753466618796987.

Jazyk angličtina Země Anglie, Velká Británie Médium print

Typ dokumentu časopisecké články, pozorovací studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid30232933

INTRODUCTION: In recognition of the value of long-term real-world data, a postauthorization safety study of the inhaled corticosteroid (ICS) fluticasone propionate and long-acting β2-agonist (LABA) formoterol fumarate (fluticasone/formoterol; Flutiform®) was conducted. METHODS: This was a 12-month observational study of outpatients with asthma aged ⩾ 12 years in eight European countries. Patients were prescribed fluticasone/formoterol according to the licensed indication, and independently of their subsequent enrolment in the study. They were then treated according to local standard practice. The study objectives were to evaluate the safety and effectiveness of fluticasone/formoterol under real-world conditions. RESULTS: The safety population for this study comprised 2539 patients (mean age 47.7 years; 94.3% aged ⩾ 18 years; 63.4% female). Most patients (1538/2539, 60.6%) had switched to fluticasone/formoterol from another ICS/LABA, primarily due to lack of efficacy (1150/2539, 45.3%). Three quarters (77.4%) of patients were treated for 12 months, and 80.6% continued fluticasone/formoterol treatment after the study. Adverse events (AEs) occurred in 60.0% patients, and 10.2% had AEs considered possibly related to fluticasone/formoterol [most commonly asthma exacerbation (2.0% patients), dysphonia (1.8%) and cough (1.1%)]. Thirty-six severe AEs, but no serious AEs, were considered possibly related to fluticasone/formoterol. The proportion of patients with controlled asthma (based on Asthma Control Test score ⩾ 20) increased from 29.4% at baseline to 67.4% at study end (last observation carried forward). The proportion of patients experiencing at least one severe exacerbation decreased from 35.8% in the year prior to enrolment to 9.8% during the study. Improvements from baseline to study end were also observed in Asthma Quality of Life scores and physician/patient reports of satisfaction with treatment. CONCLUSION: In this real-world postauthorization safety study, fluticasone/formoterol demonstrated a safety profile consistent with that seen in controlled clinical trials, with effectiveness in improving asthma control.

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European Medicines Agency Decision. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Flutiform_29/WC500125700.pdf (2012, accessed 10 April 2018).

Bodzenta-Lukaszyk A, Buhl R, Balint B, et al. Fluticasone/formoterol combination therapy versus budesonide/formoterol for the treatment of asthma: a randomized, controlled, non-inferiority trial of efficacy and safety. J Asthma 2012; 49(10): 1060–1070. PubMed

Aalbers R, Brusselle G, McIver T, et al. Onset of bronchodilation with fluticasone/formoterol combination versus fluticasone/salmeterol in an open-label, randomized study. Adv Ther 2012; 29(11): 958–969. PubMed

Bodzenta-Lukaszyk A, Dymek A, McAulay K, et al. Fluticasone/formoterol combination therapy is as effective as fluticasone/salmeterol in the treatment of asthma, but has a more rapid onset of action: an open-label, randomized study. BMC Pulm Med 2011; 11: 28. PubMed PMC

Bodzenta-Lukaszyk A, Pulka G, Dymek A, et al. Efficacy and safety of fluticasone and formoterol in a single pressurized metered dose inhaler. Respir Med 2011; 105(5): 674–682. PubMed

Corren J, Mansfield LE, Persteva T, et al. Efficacy and safety of fluticasone/formoterol combination therapy in patients with moderate-to-severe asthma. Respir Med 2013; 107(2): 180–195. PubMed

Nathan RA, D’Urzo A, Blazhko V, et al. Safety and efficacy of fluticasone/formoterol combination therapy in adolescent and adult patients with mild-to-moderate asthma: a randomised controlled trial. BMC Pulm Med 2012; 12: 67. PubMed PMC

Bodzenta-Lukaszyk A, Van Noord J, Schröder-Babo W, et al. Efficacy and safety profile of fluticasone/formoterol combination therapy compared to its individual components administered concurrently in asthma: a randomised controlled trial. Curr Med Res Opin 2013; 29(5): 579–588. PubMed

Mansur AH, Kaiser K. Long-term safety and efficacy of fluticasone/formoterol combination therapy in asthma. J Aerosol Med Pulm Drug Deliv 2013; 26(4): 190–199. PubMed

Barnes PJ. Scientific rationale for using a single inhaler for asthma control. Eur Respir J 2007; 29(3): 587–595. PubMed

Barnes PJ. Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids. Eur Respir J 2002; 19(1): 182–191. PubMed

Woolcock A, Lundback B, Ringdal N, et al. Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids. Am J Respir Crit Care Med 1996; 153(5): 1481–1488. PubMed

Greening AP, Ind PW, Northfield M, et al. Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group. Lancet 1994; 344(8917): 219–224. PubMed

Szefler SJ, Martin RJ, King TS, et al. Significant variability in response to inhaled corticosteroids for persistent asthma. J Allergy Clin Immunol 2002; 109(3): 410–418. PubMed

Ducharme FM, Ni Chroinin M, Greenstone I, et al. Addition of long-acting beta2-agonists to inhaled steroids versus higher dose inhaled steroids in adults and children with persistent asthma. Cochrane Database Syst Rev 2010(4): CD005533. PubMed PMC

Powell H, Gibson PG. Inhaled corticosteroid doses in asthma: an evidence-based approach. Med J Aust 2003; 178(5): 223–225. PubMed

Ducharme FM, Ni Chroinin M, Greenstone I, et al. Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children. Cochrane Database Syst Rev 2010(5): CD005535. PubMed PMC

Naedele-Risha R, Dorinsky P, Craig TJ. Dual components of optimal asthma therapy: scientific and clinical rationale for the use of long-acting beta-agonists with inhaled corticosteroids. J Am Osteopath Assoc 2001; 101(9): 526–533. PubMed

Marceau C, Lemiere C, Berbiche D, et al. Persistence, adherence, and effectiveness of combination therapy among adult patients with asthma. J Allergy Clin Immunol 2006; 118(3): 574–581. PubMed

Global initiative for asthma. Global strategy for asthma management and prevention, 2017, http://www.ginasthma.org (accessed 17 May 2017).

Wong GW, Miravitlles M, Chisholm A, et al. Respiratory guidelines: which real world? Ann Am Thorac Soc 2014; 11(Suppl. 2): S85–S91. PubMed

Price D, Brusselle G, Roche N, et al. Real-world research and its importance in respiratory medicine. Breathe (Sheff) 2015; 11(1): 26–38. PubMed PMC

Roche N, Reddel H, Martin R, et al. Quality standards for real-world research: focus on observational database studies of comparative effectiveness. Ann Am Thorac Soc 2014; 11(Suppl. 2): S99–S104. PubMed

Napp Pharmaceuticals Ltd. Flutiform summary of product characteristics. https://www.medicines.org.uk/emc/product/4277/smpc (accessed 10 April 2018).

Collier S, Harvey C, Brewster J, et al. Monitoring safety in a phase III real-world effectiveness trial: use of novel methodology in the Salford Lung Study. Pharmacoepidemiol Drug Saf 2017; 26(3): 344–352. PubMed PMC

New JP, Diar Bakerly N, Leather D, et al. Obtaining real-world evidence: the Salford Lung Study. Thorax 2014; 69(12): 1152–1154. PubMed PMC

Usmani OS, Kemppinen A, Gardener E, et al. A randomized pragmatic trial of changing to and stepping down fluticasone/formoterol in asthma. J Allergy Clin Immunol Pract 2017; 5(5): 1378–1387. PubMed

Schmidt O, Petro W, Hoheisel G, et al. Real-life effectiveness of asthma treatment with a fixed-dose fluticasone/formoterol pressurised metered-dose inhaler: results from a non-interventional study. Respir Med 2017; 131: 166–174. PubMed

GlaxoSmithKline. Relvar Ellipta significantly improved asthma control in Salford Lung Study patients compared with their usual care. http://www.gsk.com/en-gb/media/press-releases/relvar-ellipta-significantly-improved-asthma-control-in-salford-lung-study-patients-compared-with-their-usual-care/ (2017, accessed 17 May 2017).

Leather D, Vestbo J, Diar Bakerly N, et al. Effectiveness of fluticasone furoate/vilanterol (FF/VI) compared to usual care (UC) in patients with asthma: the Salford Lung Study (SLS). Eur Respir J 2017; 50: OA3193.

Papi A, Mansur AH, Pertseva T, et al. Long-term fluticasone propionate/formoterol fumarate combination therapy is associated with a low incidence of severe asthma exacerbations. J Aerosol Med Pulm Drug Deliv 2016; 29(4): 346–361. PubMed PMC

Little RJ, D’Agostino R, Cohen ML, et al. The prevention and treatment of missing data in clinical trials. N Engl J Med 2012; 367(14): 1355–1360. PubMed PMC

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