Study: Mild asthma patients may be overusing drug combinations

PHOENIX — Most patients with mild persistent asthma overuse a drug combination despite an apparent lack of added medical benefit, according to a new study by pharmacy benefit manager Medco.

Medco released results of the study Monday showing that nearly two-thirds of those patients are combining inhaled corticosteroids with long-acting beta agonists, even though national guidelines recommend that they use the ICS therapies alone. The company’s research arm, the Medco Research Institute, conducted the study and presented the data during the weekend at the annual scientific meeting of the American College of Allergy, Asthma and Immunology.

The company based the study on pharmacy and medical claims from 8,424 patients treated for mild asthma, finding that 5,523 were using the combination of an ICS and a LABA, while the remainder used an ICS alone. The researchers did not find a significant difference between the two groups in terms of use of acute asthma medications, emergency room visits or hospitalizations, meaning that the combination of an ICS and a LABA probably did not provide any clinical benefit compared with an ICS alone.

“This study confirms that, based on pharmacy and medical claims, patients with mild asthma using only an inhaled corticosteroid seem to control their asthma just as well as those who take a combined ICS [and] LABA treatment, such as Advair or Symbicort,” lead study researcher Luis Salmun said in a statement. “While these combination therapies are important treatments for patients with more severe asthma, it’s concerning that they are being used by a majority of patients with milder asthmatic symptoms given that these medications are more costly and that clinical guidelines prefer ICS therapy alone for these patients.”

Advair (fluticasone propionate and salmeterol) and Symbicort (budesonide and formoterol fumarate dihydrate) are made by GlaxoSmithKline and AstraZeneca, respectively.