Source: DGNews  |  Posted 2 years ago

By Micheal Casasnovas

MIAMI BEACH, Fla -- November 13, 2009 -- Paediatric patients with asthma
treated with fluticasone propionate plus salmeterol, on a fixed-dose
combination, experienced fewer serious asthma exacerbations when compared with
the use of inhaled corticosteroids plus montelukast, researchers said here at
the American College of Allergy, Asthma & Immunology (ACAAI) annual scientific
meeting.

“The use of fluticasone propionate plus salmeterol was associated with a 96%
reduced risk of having an asthma-related inpatient hospital visit and a 56%
lower risk of having an inpatient visit or an emergency department visit
compared with treatment with inhaled corticosteroids and montelukast,” reported
Richard H. Stanford, PharmD, U.S. Health Outcomes, GlaxoSmithKline, Research
Triangle Park, North Carolina, on November 8.

Dr. Stanford and colleagues compared outcomes in treatment of patients aged 4
to 11 years, who were newly started on either fluticasone propionate plus
salmeterol in a fixed-dose combination or inhaled corticosteroids plus
montelukast for the treatment of asthma.

The researchers analysed the Pharmetrics health insurance claims databases to
conduct their retrospective observational cohort study. The study period
spanned from January 2000 to January 2008.

After variable adjustments, the researchers studied outcomes involving 747
children who were taking fluticasone plus salmeterol and performed the analysis
against 747 other children who were taking inhaled corticosteroids plus
montelukast.

After adjusting for age and other demographics, the researchers observed a
hospitalisation rate of 0.28 per 100 person-years for the children taking
fluticasone plus salmeterol compared with a rate of 3.91 per 100 person-years
for the children on inhaled corticosteroids plus montelukast (P =
.0137).

Emergency department visit rate was 5.56 per 100 person-years for those taking
fluticasone plus salmeterol compared with a rate of 9.12 per 100 person-years
for the children on inhaled corticosteroids plus montelukast (P =
.232).

Hospitalisation plus emergency department visit rate was 5.84 per 100
person-years for those taking fluticasone plus salmeterol compared with a rate
of 13.02 per 100 person-years for the children on inhaled corticosteroids plus
montelukast (P = .0148).

Finally, a need for oral corticosteroid was 16.67 per 100 person-years for
those taking fluticasone plus salmeterol compared with a rate of 53.40 per 100
person-years for the children on inhaled corticosteroids plus montelukast
(P < .001).

“The use of fluticasone propionate plus salmeterol in a single device was
associated with lower asthma-related serious exacerbations compared with
inhaled corticosteroids plus montelukast in asthma patients aged 4 to 11 in a
real world managed-care setting,” said Dr. Stanford.

Funding for this study was provided by GlaxoSmithKline.

Presentation Title: Comparative Clinical and Economic Outcomes in
Children With Asthma Initiating Either Fluticasone Propionate Plus Salmeterol
or Inhaled Corticosteroids Plus Montelukast. Abstract P76