Persistencia al tratamiento y uso de recursos con corticosteroides y agonistas β-adrenérgicos de larga duración inhalados a dosis fijas para el tratamiento del asma: estudio retrospectivo de base poblacional

espanolObjetivo Determinar la persistencia, las exacerbaciones y el uso de los recursos en los pacientes que inician tratamiento inhalador con fluticasona propionato/formoterol (PF/Form) con relacion a otras combinaciones de corticoide inhalado/agonista β-adrenergico de larga duracion (CI/LABA) en dosis fijas, para el tratamiento del asma en condiciones de practica clinica habitual. Material y metodos Estudio observacional realizado a partir de la revision de registros medicos. Se incluyeron sujetos ≥18 anos que iniciaron tratamiento con CI/LABA y que cumplieran con determinados criterios de inclusion/exclusion. El seguimiento se realizo durante un ano. Grupos de estudio: a) PF/Form y b) otras-combinaciones (Otros-CI/LABA). Principales medidas: persistencia, ratio posesion del medicamento (RPM), exacerbaciones y costes (directos/indirectos). El analisis estadistico se elaboro mediante modelos de regresion, con p Resultados Se selecciono a 3.203 pacientes. Por grupos: a) PF/Form: 7,0% y b) Otros-CI/LABA: 93,0%. La edad media fue de 52,2 anos y el 60,8% fueron mujeres. El 44,9% de los pacientes presentaban un asma persistente-moderado. Los pacientes en tratamiento con PF/Form se asociaron a una mayor persistencia (67,6 vs. 61,2%; p = 0,043), mayor RPM (80,6 vs. 74,3%; p = 0,002) y menores exacerbaciones (16,0 vs. 21,9%; p = 0,021), especialmente exacerbaciones severas (4,0 vs. 7,7%; p = 0,043). El promedio/unitario del coste total (ANCOVA) fue menor en los pacientes en tratamiento con PF/Form (2.033 vs. 2.486 €; p = 0,012), respectivamente. El coste total se asocio a exacerbaciones (β = 0,618), severidad-asma (β = 0,214), edad (β = 0,073) y falta de adherencia (RPM: β = −0,031), con p Conclusiones Los pacientes en tratamiento con PF/Form se asociaron a una mayor adherencia al tratamiento (persistencia, RPM), circunstancia que repercute en menores exacerbaciones severas y costes totales para el sistema nacional de salud. Estas diferencias podrian ser debidas a las propiedades farmacologicas del farmaco o a otros factores no medidos. EnglishObjective To determine the persistence, exacerbations, and use of resources in patients who use inhaler treatment with fluticasone propionate/formoterol (PF/Form) in relation with other combinations of inhaled corticosteroid/long-acting β-adrenergic (ICS/LABA) at fixed doses, for the treatment of asthma in real-life practice. Material and methods Observational study conducted by reviewing medical records. The study included subjects ≥18 years of age who started treatment with ICS/LABA and who met certain inclusion/exclusion criteria. The follow-up was carried out for one year. Study groups: a) PF/Form and b) Other-combinations (Other-ICS/LABA). Main measurements: Persistence, medication possession ratio (MPR), exacerbations, and costs (direct/indirect). The statistical analysis was performed using regression models, with a P Results A total of 3,203 patients were included in the study. By groups: a) FP/Form: 7.0% and b) Other-ICS/LABA: 93.0%. The mean age was 52.2 years, and 60.8% were women. A total of 44.9% of patients had persistent-moderate asthma. Patients under treatment with FP/Form were associated with greater persistence (67.6 vs. 61.2%, P=.043), a higher RPM (80.6 vs. 74.3%, P=.002), and less exacerbations (16.0 vs. 21.9%, P=.021), particularly severe-exacerbations (4.0 vs. 7.7%, P=.043). The mean/unit of the total cost (ANCOVA) was lower in patients under treatment with PF/Form (2,033 vs. € 2,486, P=.012), respectively. The total cost was associated with: Exacerbations (β=0.618), asthma-severity (β=0.214), age (β=0.073), and lack-adherence (RPM: β=−0.031), P Conclusions Patients undergoing treatment with PF/Form were associated with greater adherence to treatment (persistence, RPM), a circumstance that leads to less severe exacerbations and total costs for the national health system. These differences could be due to the pharmacological properties of the drug or other factors not measured.