Improved Adherence and Asthma Control With Mometasone Furoate Over Fluticasone Propionate Among Adolescents and Young Adults With Mild Asthma
Authors: H.S. Friedman, P. Navaratnam, J. McLaughlin
Journal: Journal of Allergy and Clinical Immunology (2010)

RATIONALE: Poor adherence is common among adolescents who fail to recognize or ignore the need for daily controller therapy for persistent asthma to ensure adequate asthma control. As such, adherence and markers of asthma control (measured by short-acting β2-agonist [SABA] use and exacerbations) were examined among adolescent and adult patients receiving mometasone furoate (MF) or fluticasone propionate (FP).METHODS: A retrospective insurance claims database analysis (Ingenix LabRx) assessed adherence and asthma control among 12-25 year old patients with mild asthma who previously received controller therapy. Patients received MF or FP for 1 year following an initial prescription index date between January 1, 2005 and October 1, 2007. All patients were enrolled in health plans for ≥1 year pre- and postindex. Multivariate linear regression was used to compare postindex adherence, SABA canister claims, and exacerbations.RESULTS: MF and FP patients (n=2544 per group) were matched 1:1 based on preindex demographics, comorbidities, and asthma resource claims. Postindex adherence (measured by percent of days covered) was significantly higher with MF vs FP (28% vs 16%, respectively; P<0.0001), whereas postindex SABA canister claims were significantly lower with MF vs FP (0.9 vs 1.2, respectively; P<0.0001). In addition, the mean incidence of postindex exacerbations was significantly lower with MF vs FP (0.15 vs 0.17, respectively; P=0.04).CONCLUSIONS: Adolescent/young adult patients with mild asthma who received MF had better postindex adherence and fewer SABA claims or exacerbations than patients receiving FP. These data provide evidence for improved asthma control by MF, which may be partly due to better adherence. RATIONALE: Poor adherence is common among adolescents who fail to recognize or ignore the need for daily controller therapy for persistent asthma to ensure adequate asthma control. As such, adherence and markers of asthma control (measured by short-acting β2-agonist [SABA] use and exacerbations) were examined among adolescent and adult patients receiving mometasone furoate (MF) or fluticasone propionate (FP). METHODS: A retrospective insurance claims database analysis (Ingenix LabRx) assessed adherence and asthma control among 12-25 year old patients with mild asthma who previously received controller therapy. Patients received MF or FP for 1 year following an initial prescription index date between January 1, 2005 and October 1, 2007. All patients were enrolled in health plans for ≥1 year pre- and postindex. Multivariate linear regression was used to compare postindex adherence, SABA canister claims, and exacerbations. RESULTS: MF and FP patients (n=2544 per group) were matched 1:1 based on preindex demographics, comorbidities, and asthma resource claims. Postindex adherence (measured by percent of days covered) was significantly higher with MF vs FP (28% vs 16%, respectively; P<0.0001), whereas postindex SABA canister claims were significantly lower with MF vs FP (0.9 vs 1.2, respectively; P<0.0001). In addition, the mean incidence of postindex exacerbations was significantly lower with MF vs FP (0.15 vs 0.17, respectively; P=0.04). CONCLUSIONS: Adolescent/young adult patients with mild asthma who received MF had better postindex adherence and fewer SABA claims or exacerbations than patients receiving FP. These data provide evidence for improved asthma control by MF, which may be partly due to better adherence.