Work

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

Year: 2025

Type: article

Abstract: 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. CONCLUSIONS: Patients with asthma in Japan who initiated FF/UMEC/VI SITT had significantly better treatment adherence than those who initiated MITT.

Source: Respiratory Investigation

DOI: 10.1016/j.resinv.2025.04.017