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A Comparison of the Effectiveness of Asthma Medications on Asthma Exacerbations in Real World National Cohort

Authors
 Hye Jung Park  ;  Soyoung Jeon  ;  Hye Sun Lee  ;  Bo Yeon Kim  ;  Yu Jin Chae  ;  Gui Ok Kim  ;  Jung-Won Park  ;  Jae-Hyun Lee 
Citation
 JOURNAL OF ASTHMA AND ALLERGY, Vol.15 : 1155-1165, 2022-08 
Journal Title
JOURNAL OF ASTHMA AND ALLERGY
ISSN
 * 
Issue Date
2022-08
Keywords
asthma ; combination ; drug ; exacerbation ; medication ; real-world data
Abstract
Background: Although a wide variety of asthma medications have been developed and are used in clinical practice, there is limited evidence of their comparative effects on asthma exacerbations.

Methods: We used claims data provided by the Health Insurance Review and Assessment Service. We selected subjects commencing asthma treatment between July 1, 2017 and June 30, 2018, with no change in drug regimen. The primary outcome was asthma exacerbation requiring systemic corticosteroids. Cox regression analysis was used to assess outcomes considering the exacerbation-free period.

Results: Of the 254,951 asthma subjects, 107,694 subjects (42.2%) experienced asthma exacerbation. Inhaled corticosteroids (ICSs) (hazard ratio [HR], 0.378-0.508), ICS-long-acting β 2-agonist (LABAs) (HR, 0.284-0.479), long-acting muscarine antagonists (LAMAs) (HR, 0.432-0.572), leukotriene receptor antagonists (LTRAs) (HR, 0.371-0.419), and xanthines (HR, 0.326-0.482) significantly reduced the rate of first and second exacerbation of asthma (all P-values, <0.001). The clinical effectiveness of asthma medications varied according to the active ingredient (HR 0.164-0.670) and was significant for all active ingredients (all P-values, <0.001). The effectiveness of combination treatment using ICS-LABA and LTRA varied (HR, 0.159-0.670); however, all combination treatment options evaluated were effective in preventing asthma exacerbations (all P-values, <0.001). Long-term use of ICS-LABA (HR, 0.278-0.653), LTRA (HR, 0.259-0.628), and xanthines (HR, 0.351-0.783) showed consistent effectiveness (all P-values, <0.001).

Conclusion: This real-world study showed that the effectiveness of asthma medications varied according to drug type, active ingredient, combination, and period of use, although effectiveness was significant in all cases studied.
Files in This Item:
T202204598.pdf Download
DOI
10.2147/jaa.s379394
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191846
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