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. 2023 Nov:218:107377.
doi: 10.1016/j.rmed.2023.107377. Epub 2023 Jul 29.

A network meta-analysis of the association between patient traits and response to regular dosing with ICS/long-acting β2-agonist plus short-acting β2 agonist reliever or maintenance and reliever therapy for asthma

Arzu Yorgancıoğlu  1 , Alvaro A Cruz  2 , Gabriel Garcia  3 , Kim L Lavoie  4 , Nicolas Roche  5 , Abhijith P G  6 , Manish Verma  7 , Anurita Majumdar  8 , Swarnendu Chatterjee  9
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Free article

A network meta-analysis of the association between patient traits and response to regular dosing with ICS/long-acting β2-agonist plus short-acting β2 agonist reliever or maintenance and reliever therapy for asthma

Arzu Yorgancıoğlu et al. Respir Med. 2023 Nov.
Free article

Abstract

Introduction: Current treatment for moderate-severe asthma with inhaled corticosteroid (ICS)-based therapy can follow two strategies: a single inhaler maintenance and reliever therapy (MART) regimen, or regular dosing with ICS/long-acting β2-agonist used as maintenance therapy plus a separate short acting β2-agonist reliever inhaler. It would be clinically useful to understand the potential of patient traits to influence regular dosing or MART treatment outcomes.

Objectives: A systematic literature review (SLR) and meta-analysis was conducted to identify specific patient traits that may predict improved clinical outcomes with regular dosing or MART.

Results: The SLR identified 28 studies in patients with moderate-severe asthma assessing regular dosing or MART treatments and reporting the traits and outcomes of interest. Network meta-regressions found no significant difference in the relative efficacy of regular dosing as compared with MART on any of the clinical outcomes (exacerbation rate, time to first exacerbation, FEV1, reliever use and adherence) for any of the patient traits (baseline lung function, baseline ACQ, age, BMI, and smoking history) evaluated. However, some trends towards traits influencing treatment efficacy were identified. Inconsistent reporting of traits and outcomes was observed between trials.

Conclusions: The analysed patient traits evaluated in this study were associated with similar efficacy for the analysed outcomes to either regular dosing or MART; however, trends from the data observed encourage future analyses for possible identification of additional traits, or a combination of traits, that may be of interest. More comparable reporting of clinically important traits and outcomes would improve future analyses.

Keywords: Asthma; Maintenance therapy; Patient characteristics; Reliever therapy.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Arzu Yorgancıoğlu has received research grants from Novartis, MSD, AstraZeneca, and Sanofi, and has acted as a speaker/consultant for AstraZeneca, Abdi İbrahim, GSK, Novartis, Chiesi and Bilim. Alvaro Cruz has received personal fees from GSK, AstraZeneca, Sanofi, Boehringer Ingelheim, Chiesi, Crossjet, Eurofarma, Abdi Ibrahim and Glennmark. Gabriel Garcia has received research grants from Novartis, GSK, Boehringer Ingelheim, AstraZeneca, and Sanofi, and for acting as a consultant/advisor/speaker for GSK, AstraZeneca, Novartis, and Sanofi. Kim L. Lavoie has received consulting fees/speaker fees from GSK, Abbvie, Boehringer Ingelheim, Janssen, Bausch, Astellas, Novartis, AstraZeneca, X-Facto and Sojecci Inc. Nicolas Roche has received grants and personal fees from Boehringer Ingelheim, Novartis, Pfizer, GSK and personal fees from Austral, Biosency, MSD, AstraZeneca, Chiesi, Sanofi, Zambon. Abhijith PG was employed by GSK at the time of the study. Manish Verma, Anurita Majumdar and Swarnendu Chatterjee are full time employees of GSK and hold stocks/shares in GSK.

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