Abstract
Introduction: Factors driving exacerbation risk (ExR) are not fully characterised in asthma. We developed a model describing ExR in patients (Pts) on regularly dosed fluticasone propionate (FP), or combination therapy with FP-salmeterol (FP/SAL) or budesonide-formoterol (BUD/FOR).
Aims and objectives: To quantify the effects of symptom control (assessed by the Asthma Control Questionnaire [ACQ-5]) and treatment on ExR in moderate-severe asthma.
Methods: Exacerbations and ACQ-5 profiles were simulated over 1 year using time-to-event and longitudinal model-based parallel study designs. In addition, to reflect clinical practice, Pts on FP without adequate symptom control after 3 months were switched to FP/SAL (FPNR → FP/SAL). A log-rank test analysed cumulative exacerbation data. Heat maps separated effects of baseline characteristics from treatment effects.
Results: ACQ-5, body mass index (BMI), sex and % predicted FEV1 were ExR factors distinct from treatment effect (p<0.01). Cumulative exacerbation events (%) were fewer in Pts with well and not well controlled symptoms at baseline vs poor control (p<0.01). Switching from FP to FP/SAL significantly reduced ACQ-5 scores (p<0.01; Fig 1).
Conclusions: Symptom control, BMI and sex contribute to ExR, irrespective of treatment. These scenarios quantify the effect of treatable traits and treatment choices in moderate-severe asthma.
Funding: GlaxoSmithKline (Study 215310)
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 4572.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2022
