Comparing LAMA with LABA and LTRA as add-on therapies in primary care asthma management

Kaplan, Alan; FitzGerald, J. Mark; Buhl, Roland; Vogelberg, Christian; Hamelmann, Eckard

doi:10.1038/s41533-020-00205-9

Cited by 12 publications

(7 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, more than half of the patients with asthma were prescribed LTRA for a long duration; this is in line with LTRA use in other countries – for example, a retrospective cohort study of medical and pharmacy claims database in the United States showed that 62% of patients who initiated triple therapy, received LTRA. 23 Evidence from several studies that investigated the efficacy of ICS/LABA compared with ICS + LTRA showed superior benefits on lung function and exacerbations in favour of ICS/LABA; 24,25 however, we could not compare the effects of ICS + LTRA and ICS/LABA in this study due to overlapping prescriptions. Despite enrolling patients managed at tertiary-care centres, our study included multiple centres with wide geographical representation across China, and the frequency of SABA over-prescription was substantially lower than that observed among patients managed at tertiary-care centres in other countries.…”

Section: Discussionmentioning

confidence: 93%

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Bao

Zhang

Hang

et al. 2022

Ther Adv Respir Dis

View full text Add to dashboard Cite

Objectives: The SABINA CHINA study aimed to determine prescription data for asthma medication with a focus on SABA and ICS in a representative population of patients with asthma in China. Methods: SABINA China was a multicentre, observational, cross-sectional study with data collected retrospectively from a convenience sample of 25 tertiary centres across China. Patients (age ⩾ 12 years) with ⩾3 consultations/year were enrolled. Data were collected on clinical characteristics, asthma severity, and symptom control (as per GINA 2017), treatment and history of severe exacerbations over the past year. SABA over-prescription was defined as ⩾3 SABA canisters/year. Descriptive statistics are presented. Results: Between March and August 2020, 498 patients were included in the outcome analysis. Mean (SD) age was 48.7 (15.0) years, 57.9% were female and 91% had moderate-to-severe asthma ( n = 453). Overall, 12.5% ( n = 62) and 26.4% ( n = 131) of patients had uncontrolled and partly controlled asthma, respectively. SABA add-on was prescribed to 20.3% ( n = 101) of patients; one patient with moderate-to-severe asthma was prescribed SABA-alone. SABA over-prescription in the overall population was 4.0% ( n = 20; all with moderate-to-severe asthma) and 19.8% (20/101) among those prescribed SABA add-on. In the mild asthma group, 50% ( n = 22) were prescribed ICS/LABA and 43.2% ( n = 19) were prescribed LTRA. Among those with moderate-to-severe asthma, 97.4% ( n = 441) were prescribed ICS/LABA and 55.0% ( n = 249) were prescribed LTRA. Approximately 30% of patients ( n = 149) experienced ⩾1% and 6.6% ( n = 33) ⩾3 severe exacerbations in the preceding year; mean annual number of severe exacerbation/patient was 0.6 (1.2). Among those prescribed SABA add-on, ICS/LABA and LTRA (non-mutually exclusive groups due to overlapping prescriptions), 54.5%, 29.9%, and 35.3% had ⩾1 severe exacerbations, respectively. Conclusion: Among patients with predominantly moderate-to-severe asthma managed in tertiary care and were prescribed SABA, 1 in 5 received ⩾3 canisters/year. Fewer patients who received ICS/LABA prescriptions experienced annual exacerbations than those prescribed SABA add-on.

show abstract

Section: Discussionmentioning

confidence: 93%

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Bao

Zhang

Hang

et al. 2022

Ther Adv Respir Dis

View full text Add to dashboard Cite

show abstract

“…There are now at least three studies of a direct comparison of LAMA to LABA, all tiotropium versus salmeterol, when added to ICS in severe 22 , moderate 27 , and mild-moderate 26 asthma, all showing a similar or greater FEV 1 response with the LAMA. A recent review by Kaplan et al (2020) concluded that LAMAs yield a greater improvement in lung function than LABAs, and are as effective as LABAs with respect to achieving asthma control and preventing exacerbations 42 . Some patients have side effects on LABAs, and some patients respond better to either one of both drugs, making the use of LAMAs a viable alternative to LABA 43 .…”

Section: Positioningmentioning

confidence: 99%

Understanding the role of long-acting muscarinic antagonists in asthma treatment

Muiser¹,

Gosens²,

Berge³

et al. 2022

Annals of Allergy, Asthma & Immunology

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…Bronchodilators such as β2 agonists and muscarinic antagonists as add-on ICS can improve lung function, control symptoms, and reduce exacerbations. 5 β2 agonist can be combined with ICS if the condition of asthma exacerbation is moderate or severe. Meanwhile, patients with mild asthma can be used β2 agonist and low dose ICS combination when asthma exacerbations occur or before physical activity that can trigger worsening asthma symptoms.…”

Section: Introductionmentioning

confidence: 99%

Patterns of bronchodilator therapy in asthmatic outpatients

Aryani

Rahmawati

Cintyadewi

et al. 2023

J. Public Health Afr.

View full text Add to dashboard Cite

Background: Bronchodilators are used to treat asthma symptoms. The administration of this therapy can be given through monotherapy or in combination to achieve the maximum therapeutic effect. Objective: This study aimed to examine the prescribing pattern of bronchodilators in asthmatic outpatients. Methods: A retrospective study was done by reviewing and analyzing medical records of asthmatic outpatients from January 2019 until December 2020. Data analysis was performed descriptively. Results: In this study, bronchodilators were administered by inhalation 97.4% compared to oral routes 2.6%. Combination bronchodilator therapy showed 54.7% compared to monotherapy by 46.3%. The combination ICS/LABA budesonide/formoterol 160/4.5 mcg was the most widely used 45.7%. Conclusion: The use of a bronchodilator was in accordance with the Global Initiative for Asthma guidelines. The route of drug administration through inhalation is more widely used than oral. Combination bronchodilators were more recommended than bronchodilator monotherapy to control asthma symptoms.

show abstract

Comparing LAMA with LABA and LTRA as add-on therapies in primary care asthma management

Cited by 12 publications

References 87 publications

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Understanding the role of long-acting muscarinic antagonists in asthma treatment

Patterns of bronchodilator therapy in asthmatic outpatients

Contact Info

Product

Resources

About