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]
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