Treatment with inhaled mometasone furoate reduces short-acting β(2) agonist claims and increases adherence compared to fluticasone propionate in asthma patients.

Abstract

OBJECTIVES:

Differences between mometasone furoate (MF), administered once daily, and fluticasone propionate (FP), administered twice daily, dosing regimens may affect adherence and short-acting β(2) agonist (SABA) use. The objective of this analysis was to compare asthma control outcomes in matched cohorts of MF- and FP-treated asthma patients stratified by SABA claims.

METHODS:

A retrospective pharmacy claims database analysis identified matched cohorts of asthma patients (aged 12-65 years) who initiated treatment with MF or FP. Patients with none, one to four, five to eight, or more than eight SABA preindex claims were stratified to categories A, B, C, and D, respectively. Bivariate analyses compared postindex SABA canister claims, adherence, and exacerbations; multivariate analyses compared postindex SABA canister claims.

RESULTS:

Matched patients in categories A (n = 2517 per cohort) and B (n = 2329 per cohort) were analyzed; insufficient sample sizes were identified for categories C and D. Postindex bivariate analyses indicated that MF cohorts had fewer SABA claims compared to FP cohorts (category A, 0.80 vs. 1.17 [P < 0.0001]; category B, 1.39 vs. 1.58 [P < 0.0001]), better adherence to the index drug (category A, 24% vs. 15% [P < 0.0001]; category B, 27% vs. 15% [P < 0.0001]), and fewer exacerbations (category A, 0.17 vs. 0.19 [P = 0.011]; category B, 0.17 vs. 0.21 [P = 0.008]). Multivariate analyses indicated that MF cohorts had fewer postindex SABA claims compared to FP cohorts in categories A and B (P < 0.0001).

CONCLUSIONS:

Data for SABA claims, treatment adherence, and exacerbations suggest that, compared to twice-daily FP, once-daily MF may provide better asthma control.

• Authors: Prakash Navaratnam, Howard S Friedman, Eduardo Urdaneta
• Journal: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (Value Health) 2011 Mar-Apr Vol. 14 Issue 2 Pg. 339-46 ISSN: 1524-4733 [Electronic] United States
• PMID: 21402302 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Chemical References

• Adrenergic beta-2 Receptor Agonists
• Androstadienes
• Anti-Asthmatic Agents
• Anti-Inflammatory Agents
• Pregnadienediols
• Mometasone Furoate
• Fluticasone

Topics

• Administration, Inhalation
• Adolescent
• Adrenergic beta-2 Receptor Agonists (administration & dosage)
• Adult
• Aged
• Analysis of Variance
• Androstadienes (administration & dosage)
• Anti-Asthmatic Agents (administration & dosage)
• Anti-Inflammatory Agents (administration & dosage)
• Asthma (drug therapy, economics)
• Child
• Cohort Studies
• Disease Progression
• Female
• Fluticasone
• Humans
• Insurance Claim Review
• Male
• Medication Adherence
• Middle Aged
• Mometasone Furoate
• Outcome Assessment, Health Care
• Pregnadienediols (administration & dosage)
• Retrospective Studies
• United States
• Young Adult