Table 4.
Outcomes for patients initiating ICS or receiving an increased dose of ICS via pressurized metered-dose inhaler, breath-actuated inhaler, or dry powder inhaler
|
Initiation population (N = 56,347) |
Step-up population (N = 9169) |
|||||||
|---|---|---|---|---|---|---|---|---|
| pMDI (N = 39,746) | BAI (N = 9809) | DPI (N = 6792) | P-value | pMDI (N = 6245) | BAI (N = 1388) | DPI (N = 1536) | P-value | |
| Asthma control status | ||||||||
| Primary measure of asthma control | 29,961 (75.4) | 7518 (76.6) | 5307 (78.1) | 4237 (67.8) | 1032 (74.4) | 1103 (71.8) | ||
| Asthma control plus SABA use | 21,956 (55.2) | 5605 (57.1) | 4185 (61.6) | 2289 (36.7) | 584 (42.1) | 610 (39.7) | ||
| Severe asthma exacerbations | ||||||||
| 0 | 33,799 (85.0) | 8366 (85.3) | 5918 (87.1) | 4840 (77.5) | 1144 (82.4) | 1254 (81.6) | ||
| 1 | 4407 (11.1) | 1061 (10.8) | 658 (9.7) | 850 (13.6) | 166 (12.0) | 180 (11.7) | ||
| 2 | 978 (2.5) | 255 (2.6) | 131 (1.9) | 310 (5.0) | 52 (3.7) | 55 (3.6) | ||
| ≥3 | 562 (1.4) | 127 (1.3) | 85 (1.3) | 245 (3.9) | 26 (1.9) | 47 (3.1) | ||
| Disaggregated outcomes of the composite measures: | ||||||||
| ≥1 oral corticosteroid course | 5938 (14.9) | 1442 (14.7) | 874 (12.9) | 0.001 | 1400 (22.4) | 242 (17.4) | 282 (18.4) | <0.001 |
| ≥1 hospital attendance | 26 (0.1) | 14 (0.1) | 0 (0) | 0.002 | 16 (0.3) | 2 (0.1) | 2 (0.1) | 0.519 |
| ≥1 course of antibiotics for LRTI | 5079 (12.8) | 1145 (11.7) | 798 (11.7) | 0.003 | 970 (15.5) | 177 (12.8) | 219 (14.3) | 0.108 |
| Mean SABA dose > 200 μg/daya | 11,832 (29.8) | 2779 (28.3) | 1605 (23.6) | <0.001 | 3152 (50.5) | 661 (47.6) | 739 (48.1) | 0.066 |
| Change in or additional therapy | 5501 (13.8) | 1583 (16.1) | 1099 (16.2) | <0.001 | 1693 (27.1) | 318 (22.9) | 444 (28.9) | 0.001 |
| Increase in ICS dose | 2908 (7.3) | 959 (9.8) | 602 (8.9) | – | 320 (5.1) | 75 (5.4) | 104 (6.8) | – |
| Use of additional Rx for asthma | 3256 (8.2) | 834 (8.5) | 645 (9.5) | – | 1532 (24.5) | 266 (19.2) | 386 (25.1) | – |
Notes: Values shown are n (%). P-values for comparison among the three cohorts calculated with χ2 test for categorical data;
a
The short-acting β-agonist dose is the albuterol dose equivalent (standard dose in UK is 100 μg).
Abbreviations: BAI, breath-actuated inhaler; DPI, dry powder inhaler; ICS, inhaled corticosteroid; LRTI, lower respiratory tract infection; pMDI, pressurized metered-dose inhaler; SABA, short-acting β2 agonist.