Triple drug inhalation with single inhaler increases adherence in asthma patients

USA: Patients with asthma who started triple treatment with single-inhaler fluticasone furoate/ umeclidinium/ vilanterol (FF/UMEC/VI) showed considerably greater adherence and persistence than those who started multiple-inhaler triple therapy (MITT), says an article published in The Journal of Allergy and Clinical Immunology.

For individuals with uncontrolled asthma on inhaled corticosteroid/long-acting 2-agonist medication, treatment guidelines indicate triple therapy. Previously, triple treatment was only offered through the use of numerous inhalers. As a maintenance therapy for asthma, single-inhaler fluticasone furoate/ umeclidinium/ vilanterol is licensed; however, real-world data on adherence and persistence is inadequate.

As a result, William W. Busse and colleagues undertook this research in the United States to assess adherence and persistence among adult asthma patients taking single-inhaler FF/UMEC/VI versus multiple-inhaler triple treatment.

Patients with asthma who started once-daily FF/UMEC/VI 100/62.5/25 mcg or MITT between September 18, 2017, and September 30, 2019, were evaluated in this retrospective cohort study using IQVIA PharMetrics Plus data. Adjusted for variations in features between the FF/UMEC/VI and MITT groups using inverse probability weighting and multivariable regression. Adherence was measured using the proportion of days covered (PDC) and the proportion of patients who achieved PDCs of ≥0.8 and ≥0.5. Non-persistence was defined as a gap of more than 45 days between fillings.

The key findings of this study were as follows:

1. The study includes 1396 FF/UMEC/VI initiators and 5115 MITT initiators.

2. Three months after starting, FF/UMEC/VI users had a considerably higher mean PDC than MITT users and were 31% more likely to adhere.

3. Similar results were found 6 and 12 months after treatment began.

4. Furthermore, FF/UMEC/VI users were 49% more likely to stick around after 12 months than MITT users.

In conclusion, to enhance both adherence and outcomes for asthma patients, the researchers suggested training programs, electronic monitoring devices, and frequent monitoring of adherence and inhaler skills.

Reference:

Busse, W. W., Abbott, C. B., Germain, G., Laliberté, F., MacKnight, S. D., Jung, Y., Duh, M. S., & Averell, C. M. (2022). Adherence and Persistence to Single-Inhaler Versus Multiple-Inhaler Triple Therapy for Asthma Management. In The Journal of Allergy and Clinical Immunology: In Practice. Elsevier BV. https://doi.org/10.1016/j.jaip.2022.06.010