Long-acting Beta2-agonist and inhaled corticosteroid combination therapy for adult persistent asthma: systematic review of clinical outcomes and economic evaluation
Bond K, Coyle D, O'Gorman K, Coyle K, Spooner C, Lemiere C, Vandermeer B, Tjosvold L, Rowe BH
Record ID 32010000185
English
Authors' recommendations:
This review confirms that for most patients with persistent asthma, initial therapy and the only therapy that is needed is ICS. The LABA-ICS combination provides some benefit that is limited in the range of symptoms for which control is improved and in the clinical meaningfulness of the improvements. The efficacy and safety results suggest that there are often statistically significant but not clinically meaningful benefits from switching to combination therapy for the management of most asthma that is not controlled by the use of ICS. For asthma that is controlled on ICS, the addition of a LABA may help to reduce the amount of daily ICS used and may thereby reduce the risk that is associated with prolonged use of daily high- and moderate-dose ICS. In addition, the number and severity of exacerbations can be reduced with this management strategy. There are no clinically important differences between LABA-ICS combination therapies. The cost-effectiveness analysis suggests that the introduction of a LABA before patients have tried high-dose ICS monotherapy may not be justified. The later a LABA is introduced into therapy, the more cost-effective the strategy becomes. The optimum strategy among the four that were considered occurred when patients started using a LABA after their asthma was uncontrolled by high doses of ICS. A sensitivity analysis revealed that these results were insensitive to changes in relevant parameters.
Details
Project Status:
Completed
URL for project:
http://www.cadth.ca/media/pdf/480_LABA_&_ICCT_for_Adult_Persistent_Asthma_tr_e.pdf
Year Published:
2009
URL for published report:
https://www.cadth.ca/media/pdf/480_LABA_&_ICCT_for_Adult_Persistent_Asthma_tr_e.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Administration, Inhalation
- Adrenal Cortex Hormones
- Adrenergic beta-Agonists
- Anti-Asthmatic Agents
- Asthma
- Cost-Benefit Analysis
Contact
Organisation Name:
Canadian Agency for Drugs and Technologies in Health
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Agency for Drugs and Technologies in Health
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