Prescribing of long-acting beta-2-agonists/inhaled corticosteroids after the SMART trial

Marietta Rottenkolber, Rainald Fischer, Luisa Ibáñez, Joan Fortuny, Robert Reynolds, Justyna Amelio, Roman Gerlach, Martin Tauscher, Petra Thürmann, Joerg Hasford, Sven Schmiedl

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)

Abstract

© Rottenkolber et al.; licensee BioMed Central. Background: After the SMART trial evaluating the safety of salmeterol (long-acting beta-2-agonist (LABA)) in asthma patients, regulatory actions were taken to promote a guideline-adherent prescribing of LABA only to patients receiving inhaled corticosteroids (ICS). We aim to analyse LABA- and ICS-related prescription patterns after the SMART trial in Germany. Methods: Patients documented in the Bavarian Association of Statutory Health Insurance Physicians database (approximately 10.5 million people) were included if they had a diagnosis of asthma and at least one prescription of LABA and/or ICS between 2004 and 2008. Annual period prevalence rates (PPRs) were estimated and Cochrane Armitage tests were used for time trend analyses. Results: Highest annual PPRs were found for budesonide and the fixed combination of salmeterol/fluticasone. The proportion of "concomitant LABA and ICS users" increased from 52.0 to 57.6% within the study period, whereas for "LABA users without ICS" a slight decrease from 6.5 to 5.4% was found. In 2008, the proportion of patients with at least one quarter with a LABA prescription without concomitant ICS was highest in elderly, male patients (≈20%). In the majority of these patients, a concomitant diagnosis of COPD (i.e. asthma-COPD overlap syndrome [ACOS]) was present. Conclusions: Between 2004 and 2008, we found a moderate increase in guideline-adherent LABA prescribing in a representative German population. Elderly men received a significant number of LABA prescriptions without concomitant ICS probably due to ACOS.
Original languageEnglish
Article number55
JournalBMC Pulmonary Medicine
Volume15
Issue number1
DOIs
Publication statusPublished - 6 May 2015

Keywords

  • ACOS
  • Asthma
  • COPD
  • Drug regulatory actions
  • Drug utilisation study
  • Inhaled corticosteroids
  • Long-acting adrenergic beta-2-receptor agonists
  • SMART trial

Fingerprint Dive into the research topics of 'Prescribing of long-acting beta-2-agonists/inhaled corticosteroids after the SMART trial'. Together they form a unique fingerprint.

Cite this