d630ac45a1ff08748a7dbd17d00c9eba 296653.pdf 3021057da80006595a449cbf7f889265bb740ddc 296653.pdf f4c7c9ca81bc9c39245d47d60ae5a0c4385dcd5c5b374c9efdfeea126697d5ba 296653.pdf Title: Comprehensive Observational Study in a Large Cohort of Asthma Patients after Adding LAMA to ICS/LABA Subject: Introduction: Adding LAMA to LABA/ICS is recommended to improve control in patients with persistent asthma. Methods: This observational, retrospective, before-and-after study considered patients diagnosed with asthma who started LABA/ICS + LAMA treatment (triple therapy, TT) between 1 January 2017 and 31 December 2018 and had been treated with LABA/ICS (dual therapy, DT) in the year before. Changes in lung function and exacerbation rates, healthcare resource utilization, and healthcare and non-healthcare costs (€2019) were estimated in patients with asthma in clinical practices in Spain. Data from computerized medical records from seven Spanish regions were collected 1 year of LAMA addition. Results: 4740 patients (64.1 years old [SD: 16.3]) were included. TT reduced the incidence of exacerbations by 16.7% (p < 0.044) and the number of patients with exacerbations by 8.5% (p < 0.001) compared to previous DT. The rate of patients with severe exacerbations requiring systemic corticosteroids and their hospitalization rates significantly decreased by 22.5% and 29.5%. TT significantly improved FEV1, FVC, and FEV1/FVC, saving €571/patient for society. Younger patients with asthma (18–44 years old) and patients with severe asthma (FEV1 < 60%) performed better upon the initiation of TT. Conclusions: TT reduced asthma exacerbations, improved lung function and reduced healthcare costs vs. DT, particularly in patients requiring systemic corticosteroids to treat severe exacerbations. Keywords: dual therapy; triple therapy; asthma; long-acting muscarinic antagonists; exacerbations; costs Author: Vicente Plaza, Javier Domínguez-Ortega, Diego González-Segura Alsina, Daniele Lo Re and Antoni Sicras-Mainar Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Nov 14 16:08:36 2023 CET ModDate: Tue Nov 14 16:47:23 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 790394 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- SSNIUI+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 OSZXWL+VnURWPalladioL Type 1 Custom yes yes no 15 0 TYXZJT+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 URZUCO+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 PAAZXL+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 UJUUJI+PazoMath Type 1 Builtin yes yes no 32 0 KOSUXD+CMSY10 Type 1 Builtin yes yes no 36 0 VWRBXB+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 54 0 CAMXTK+EURM10 Type 1 Builtin yes yes no 76 0 PIIHLF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 88 0 PIIHLG+PalatinoLinotype CID TrueType Identity-H yes yes yes 91 0 PIIHLH+PalatinoLinotype TrueType WinAnsi yes yes no 97 0 PIIHLJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 100 0 PIIIEH+PalatinoLinotype TrueType MacRoman yes yes no 103 0 PIIIOE+TimesNewRoman CID TrueType Identity-H yes yes yes 106 0 FAECIJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 118 0 BHHMKI+PazoMath-Italic Type 1 Builtin yes yes no 128 0 PIIHLE+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 142 0 PIIJFE+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 148 0 PIIHLF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 151 0 PIIHLG+PalatinoLinotype CID TrueType Identity-H yes yes yes 154 0 PIIHLH+PalatinoLinotype TrueType WinAnsi yes yes no 160 0 PIIHLI+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 163 0 PIIHLJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 169 0 PZIJIN+PazoMath-Bold Type 1 Builtin yes yes no 176 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-07-27 02:46:03 CEST RepresentationInformation: 296653.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-07-26 11:59:04 CEST Size: 790394 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 395 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Treatments Destination: subsection.2.2 Item: Title: Clinical Outcomes and Deaths Destination: subsection.2.3 Children: Item: Title: Severe Exacerbations and Deaths Destination: subsubsection.2.3.1 Item: Title: Lung Function and Eosinophil Counts Destination: subsubsection.2.3.2 Item: Title: Use of Healthcare Resources and Costs Destination: subsection.2.4 Item: Title: Discussion Destination: section.3 Item: Title: Materials and Methods Destination: section.4 Children: Item: Title: Study Population and Design Destination: subsection.4.1 Item: Title: Demographic Variables, Comorbidities, and Treatments Destination: subsection.4.2 Item: Title: Clinical Outcomes and Deaths Destination: subsection.4.3 Item: Title: Resource Use and Costs Destination: subsection.4.4 Item: Title: Statistical Analyses Destination: subsection.4.5 Item: Title: Compliance with Ethics Destination: subsection.4.6 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Comprehensive Observational Study in a Large Cohort of Asthma Patients after Adding LAMA to ICS/LABA Author: Vicente Plaza, Javier Domínguez-Ortega, Diego González-Segura Alsina, Daniele Lo Re and Antoni Sicras-Mainar Subject: Introduction: Adding LAMA to LABA/ICS is recommended to improve control in patients with persistent asthma. Methods: This observational, retrospective, before-and-after study considered patients diagnosed with asthma who started LABA/ICS + LAMA treatment (triple therapy, TT) between 1 January 2017 and 31 December 2018 and had been treated with LABA/ICS (dual therapy, DT) in the year before. Changes in lung function and exacerbation rates, healthcare resource utilization, and healthcare and non-healthcare costs (€2019) were estimated in patients with asthma in clinical practices in Spain. Data from computerized medical records from seven Spanish regions were collected 1 year of LAMA addition. Results: 4740 patients (64.1 years old [SD: 16.3]) were included. TT reduced the incidence of exacerbations by 16.7% (p < 0.044) and the number of patients with exacerbations by 8.5% (p < 0.001) compared to previous DT. The rate of patients with severe exacerbations requiring systemic corticosteroids and their hospitalization rates significantly decreased by 22.5% and 29.5%. TT significantly improved FEV1, FVC, and FEV1/FVC, saving €571/patient for society. Younger patients with asthma (18 44 years old) and patients with severe asthma (FEV1 < 60%) performed better upon the initiation of TT. Conclusions: TT reduced asthma exacerbations, improved lung function and reduced healthcare costs vs. DT, particularly in patients requiring systemic corticosteroids to treat severe exacerbations. 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