David B Price1,2, Victoria Carter3, Jessica Martin3, Elizabeth A Gardener3, Derek Skinner3, Sen Yang3, Matthias Hoffman4, Jenna C Willis5, Andrew J Cooper5. 1. Centre of Academic Primary Care, Division of Applied Health Services, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. dprice@opri.sg. 2. Observational and Pragmatic Research Institute, Singapore City, Singapore. dprice@opri.sg. 3. Observational and Pragmatic Research Institute, Singapore City, Singapore. 4. Mundipharma Research GmbH and Co. KG, Höhenstraße 10, 65549, Limburg, Germany. 5. Mundipharma Research Ltd., Cambridge Science Park, Milton Road, Cambridge, CB4 0AB, UK.
Abstract
OBJECTIVE: The inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fluticasone propionate/formoterol fumarate (FP/FORM; Flutiform®) has been available as fixed-dose combination (FDC) therapy for asthma patients aged ≥ 12 years in the UK since 2012. This post-authorisation safety study examined adverse outcomes and prescribing practices for FP/FORM and other FDC ICS/LABA therapies in a real-life clinical setting over 36 months. METHODS: Historical, longitudinal cohort database study using UK primary care data from the Clinical Practice Research Datalink (CPRD) database, for patients initiated on or switched to an FDC ICS/LABA (ENCePP study number: EUPAS12330). The main cohort was adults aged ≥ 18 years with asthma. The primary outcome was incidence of new adverse outcomes after initiation of ICS/LABA; hazard ratios (HRs) and 95% confidence intervals were estimated for FP/FORM versus other FDC ICS/LABAs using Cox regression models. RESULTS: A total of 241,007 patients with an FDC ICS/LABA prescription were identified. In the adult asthma cohort (N = 41,609), the incidence rate of new adverse outcomes [in 100 patient-years (py)] was significantly lower for FP/FORM (24.75) versus fluticasone/salmeterol metered-dose inhaler [8.86; HR 1.14 (1.04, 1.25)], fluticasone/salmeterol dry powder inhaler [31.19; HR 1.18 (1.08, 1.29)], budesonide/formoterol [25.16; HR: 1.13 (1.03, 1.25)] and beclometasone/formoterol [25.47; HR 1.14 (1.04, 1.25)]. The overall prescribing rate was lower for FP/FORM (13.85 per 1000/py) than licensed FDC ICS/LABA comparators (20.30-28.13 per 1000/py). Of those prescribed FP/FORM, 80.8% were adults with asthma and < 7% were prescribed FP/FORM "off-label". CONCLUSIONS: The results suggest that FP/FORM was associated with an overall lower adverse outcome rate than the licensed comparators.
OBJECTIVE: The inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fluticasone propionate/formoterol fumarate (FP/FORM; Flutiform®) has been available as fixed-dose combination (FDC) therapy for asthmapatients aged ≥ 12 years in the UK since 2012. This post-authorisation safety study examined adverse outcomes and prescribing practices for FP/FORM and other FDC ICS/LABA therapies in a real-life clinical setting over 36 months. METHODS: Historical, longitudinal cohort database study using UK primary care data from the Clinical Practice Research Datalink (CPRD) database, for patients initiated on or switched to an FDC ICS/LABA (ENCePP study number: EUPAS12330). The main cohort was adults aged ≥ 18 years with asthma. The primary outcome was incidence of new adverse outcomes after initiation of ICS/LABA; hazard ratios (HRs) and 95% confidence intervals were estimated for FP/FORM versus other FDC ICS/LABAs using Cox regression models. RESULTS: A total of 241,007 patients with an FDC ICS/LABA prescription were identified. In the adult asthma cohort (N = 41,609), the incidence rate of new adverse outcomes [in 100 patient-years (py)] was significantly lower for FP/FORM (24.75) versus fluticasone/salmeterol metered-dose inhaler [8.86; HR 1.14 (1.04, 1.25)], fluticasone/salmeterol dry powder inhaler [31.19; HR 1.18 (1.08, 1.29)], budesonide/formoterol [25.16; HR: 1.13 (1.03, 1.25)] and beclometasone/formoterol [25.47; HR 1.14 (1.04, 1.25)]. The overall prescribing rate was lower for FP/FORM (13.85 per 1000/py) than licensed FDC ICS/LABA comparators (20.30-28.13 per 1000/py). Of those prescribed FP/FORM, 80.8% were adults with asthma and < 7% were prescribed FP/FORM "off-label". CONCLUSIONS: The results suggest that FP/FORM was associated with an overall lower adverse outcome rate than the licensed comparators.
Authors: Anna Bodzenta-Lukaszyk; Jan van Noord; Winfried Schröder-Babo; Kirsten McAulay; Tammy McIver Journal: Curr Med Res Opin Date: 2013-02-20 Impact factor: 2.580
Authors: Mome Mukherjee; Andrew Stoddart; Ramyani P Gupta; Bright I Nwaru; Angela Farr; Martin Heaven; Deborah Fitzsimmons; Amrita Bandyopadhyay; Chantelle Aftab; Colin R Simpson; Ronan A Lyons; Colin Fischbacher; Christopher Dibben; Michael D Shields; Ceri J Phillips; David P Strachan; Gwyneth A Davies; Brian McKinstry; Aziz Sheikh Journal: BMC Med Date: 2016-08-29 Impact factor: 8.775