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New inhaler improves asthma control

A new inhaler has been shown to increase overall asthma control with no associated cost increase, according to a recent UK study.

The study featured 1958 patients with asthma – both children and adults – treated in UK primary care practices. Inhalers used included pressurised metered-dose inhalers, breath-actuated inhalers, and dry-powder inhalers, delivering beclamethasone, budesonide, fluticasone, or ciclesonide.  Patients remaining on these inhalers were matched with patients who were switched to the new Easyhaler at the same, or lower, dose. The primary clinical outcomes were risk domain asthma control – asthma-related hospitalisations, acute oral steroid use, lower respiratory tract infections (LRTI) – and exacerbation rates. Exacerbation rates were defined using the American Thoracic Society definition – asthma-related hospitalisations or acute oral steroid use – and the clinical definition which combined that with LRTIs.

Clinical outcomes and healthcare costs were compared between the groups before and after the switch.  Overall asthma control was defined as risk domain asthma control, plus an average short-acting β2 agonist (SABA) dosage of 200µg/day or less for salbutamol or 500µ/day or less for terbutaline. 

Non-inferiority was shown for the Easyhaler group in both primary outcomes. There were no significant differences between groups for risk domain asthma control or exacerbation rates, but the Easyhaler patients were 26% more likely to achieve overall asthma control compared to those who remained on the other inhalers. This was due to SABA usage – at 52% of patients, significantly more of those switched to the Easyhaler remained on a SABA dosage of 200µg/day or less, compared to just 47% of those who remained on other inhalers.

Mean asthma-related healthcare costs increased from baseline to outcome years in both groups, but SABA costs increased significantly more in non-Easyhaler patients than Easyhaler patients, with a mean difference of £5.50 per patient per year. Consultation costs were found to have decreased significantly more in patients taking Easyhaler compared to patients not taking Easyhaler – a mean difference £15.50 per patient per year.

The researchers conclude that ‘typical asthma patients may be switched from other inhaled corticosteroid devices to the Easyhaler with no reduction in clinical effectiveness or increase in cost’.

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