Observational studyPrimary care respiratory journal : journal of the General Practice Airways Group2013
Clinical and cost effectiveness of switching asthma patients from fluticasone-salmeterol to extra-fine particle beclometasone-formoterol: a retrospective matched observational study of real-world patients.
Observational study in Primary care respiratory journal : journal of the General Practice Airways Group, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Economic Evaluations Informed Exclusively by Real World Data: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Systematic Literature Review of Systemic Corticosteroid Use for Asthma Management.American journal of respiratory and critical care medicine · 2020Pooled it
- Cost Effectiveness of Pharmacological Treatments for Asthma: A Systematic Review.PharmacoEconomics · 2018Pooled it
- Small airway dysfunction measured by impulse oscillometry is associated with exacerbations and poor symptom control in patients with asthma treated in a tertiary hospital subspecialist airways disease clinic.Frontiers in allergy · 2024Article
- From the infant to the geriatric patient-Strategies for inhalation therapy in asthma and chronic obstructive pulmonary disease.The clinical respiratory journal · 2023Review
- Fixed-dose combination fluticasone/formoterol for asthma treatment in a real-world setting: meta-analysis of exacerbation rates and asthma control.European clinical respiratory journal · 2023Review
- Targeting the Small Airways with Inhaled Corticosteroid/Long-Acting Beta Agonist Dry Powder Inhalers: A Functional Respiratory Imaging Study.Journal of aerosol medicine and pulmonary drug delivery · 2021Article
- Climate change in healthcare: Exploring the potential role of inhaler prescribing.Pharmacology research & perspectives · 2020Review
- Switching Inhalers: A Practical Approach to Keep on UR RADAR.Pulmonary therapy · 2020Article
- Efficacy and Safety of a Pressurized Metered-Dose Inhaler in Older Asthmatics: Comparison to a Dry Powder Inhaler in a 12-Week Randomized Trial.Allergy, asthma & immunology research · 2020Article
- A Comparison of the Real-Life Clinical Effectiveness of the Leading Licensed ICS/LABA Combination Inhalers in the Treatment for COPD.International journal of chronic obstructive pulmonary disease · 2020Article
- Comparison of adverse events associated with different spacers used with non-extrafine beclometasone dipropionate for asthma.NPJ primary care respiratory medicine · 2019Article
- Quality standards in respiratory real-life effectiveness research: the REal Life EVidence AssessmeNt Tool (RELEVANT): report from the Respiratory Effectiveness Group-European Academy of Allergy and Clinical Immunology Task Force.Clinical and translational allergy · 2019Article
- Article
- Use of ICS/LABA (extra-fine and non-extra-fine) in elderly asthmatics.Therapeutics and clinical risk management · 2016Review
- Small airway dysfunction and bronchial asthma control : the state of the art.Asthma research and practice · 2015Review
- Small airways dysfunction in asthma: evaluation and management to improve asthma control.Allergy, asthma & immunology research · 2014Review
- Severe asthma in children.The journal of allergy and clinical immunology. In practiceReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEfficacy trials suggest that extra-fine particle beclometasone dipropionate-formoterol (efBDP-FOR) is comparable to fluticasone propionate-salmeterol (FP-SAL) in preventing asthma exacerbations at a clinically equivalent dosage. However, switching from FP-SAL to efBDP-FOR has not been evaluated in real-world asthma patients.
aimsThe REACH (Real-world Effectiveness in Asthma therapy of Combination inHalers) study investigated the clinical and cost effectiveness of switching typical asthma patients from FP-SAL to efBDP-FOR.
methodsA retrospective matched (1:3) observational study of 1,528 asthma patients aged 18-80 years from clinical practice databases was performed. Patients remaining on FP-SAL (n=1,146) were compared with those switched to efBDP-FOR at an equivalent or lower inhaled corticosteroid (ICS) dosage (n=382). Clinical and economic outcomes were compared between groups for the year before and after the switch. Non-inferiority (at least equivalence) of efBDP-FOR was tested against FP-SAL by comparing exacerbation rates during the outcome year.
resultsefBDP-FOR was non-inferior to FP-SAL (adjusted exacerbation rate ratio 1.01 (95% CI 0.74 to 1.37)). Switching to efBDP-FOR resulted in significantly better (p<0.05) odds of achieving overall asthma control (no asthma-related hospitalisations, bronchial infections, or acute oral steroids; salbutamol ≤200μg/day) and lower daily short-acting β2-agonist usage at a lower daily ICS dosage (mean -130μg/day FP equivalents; p<0.001). It also reduced mean asthma-related healthcare costs by £93.63/patient/year (p<0.001).
conclusionsAsthma patients may be switched from FP-SAL to efBDP-FOR at an equivalent or lower ICS dosage with no reduction in clinical effectiveness but a significant reduction in cost.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.