Incidence of Exacerbations and Hospitalizations Is Reduced and Time to Exacerbations Is Prolonged with Mometasone Furoate Dry Powder Inhaler Versus Beclomethasone Dipropionate Hydrofluoroalkane Aerosol in Patients with Mild Asthma

Abstract 

Objective

To compare the incidence and time to onset of exacerbations among mild asthmatic non-controller-naive patients who began treatment with mometasone furoate via a dry powder inhaler (MF-DPI) or a beclomethasone dipropionate-hydrofluoroalkane (BDP-HFA) aerosol inhaler.

Study Design

An administrative claims database was retrospectively examined from January 1, 2005 through June 30, 2008. Patients with mild asthma aged 12-65 years who were US residents and enrolled in their health plan for ≥1 year before and after the index date for MF-DPI or BDP-HFA treatment initiation were included (n=1273 matched patients per cohort). Primary evaluations included the incidence of and time to any asthma exacerbations and several asthma exacerbation subtypes. Multivariate generalized linear regression modeling analyses were used to compare the postindex incidence of exacerbations between cohorts. Cox regression analyses were conducted to control for the impact of input variables and evaluate the time to exacerbations.

Results

Significantly fewer MF-DPI patients experienced an exacerbation compared with BDP-HFA patients (9.7% vs 11.5%, respectively; P=.0002). At all time points examined, fewer MF-DPI patients compared with BDP-HFA patients experienced any exacerbation or an exacerbation requiring inpatient hospitalization. The difference between cohorts in the incidence of inpatient exacerbations increased over time. MF-DPI patients experienced prolonged time to any asthma exacerbation (hazard ratio=0.77; P=.0414) or exacerbations requiring inpatient hospitalization (hazard ratio=0.51; P=.0191) compared with BDP-HFA patients.

Conclusion

These analyses suggest that patients (previously receiving asthma-related therapy) with mild asthma receiving MF-DPI are at lower risk for asthma exacerbations compared with those receiving BDP-HFA.

Keywords: Adherence, Asthma-related therapy, Inhaled corticosteroids