Treatment Patterns and Disease Burden Associated with Multiple-Inhaler Triple-Therapy Use in Asthma

Area of Science:

• Pulmonology
• Real-world evidence
• Pharmacotherapy

Background:

• Long-acting muscarinic antagonists are recommended for uncontrolled asthma.
• This study is the first large-scale, real-world examination of multiple-inhaler triple-therapy (MITT) in asthma management.

Purpose of the Study:

• To determine the real-world prevalence of MITT in asthma patients.
• To analyze outcomes, treatment patterns, adherence, and persistence associated with MITT.

Main Methods:

• Retrospective cohort study utilizing medical and pharmacy claims data.
• Analyzed patients diagnosed with asthma between 2013 and 2018 with evidence of MITT use.
• Assessed prevalence, adherence, persistence, healthcare utilization, and costs.

Main Results:

• MITT prevalence increased from 0.35% to 1.00% between 2014/2015 and 2017/2018.
• Incident MITT users showed high disease burden, healthcare utilization, and exacerbation rates.
• Adherence and persistence to MITT were low (proportion of days covered: 0.31), with only 12% remaining on therapy at 12 months.

Conclusions:

• Multiple-inhaler triple-therapy use in asthma remains low.
• Patients initiating MITT have a substantial disease burden and significant unmet needs, suggesting challenges in treatment optimization.