Impact of extrafine single-inhaler triple therapy on treatment adherence after 6 months of treatment in asthmatics: a real-world view from Germany

Background Randomized controlled trials (RCTs) showed significant clinical benefits of extrafine single-inhaler triple therapy (efSITT) consisting of extrafine beclomethasone dipropionate/formoterol fumarate/glycopyrronium bromide (BDP/FF/G; 87/5/9 µg). The study population in the RCTs comprised asthma patients not adequately controlled on LABA and medium- or high-dose ICS, and who experienced≥1 asthma exacerbation in the previous year. The impact of efSITT on treatment adherence in asthmatics in a real-world setting is unknown.

Aims We set out to evaluate characteristics and therapy pathways in patients with moderate to severe asthma prescribed efSITT in real-world practice, and to characterize the effects on health-related outcomes.

Methods We present an interim analysis from the multicenter multicountry prospective non-interventional study TriMaximize observing asthma patients prescribed efSITT, two inhalations twice daily, for 12 to 36 months in real-world practice. Changes in treatment adherence were evaluated in the first 184 patients from Germany after 6 months of efSITT treatment. Treatment adherence was assessed by the Test of Adherence to Inhalers, a 10-item patient questionnaire ranging from 10 to 50 points classifying good (50 points), medium (46-49 points) and poor (≤45 points) adherence.

Results The majority (75%) were on prior ICS/LABA treatment, and 25% on prior triple therapy with ICS/LABA/LAMA. At baseline, the proportion of patients with a poor, medium or good treatment adherence score was 26.6%, 27.7% and 45.7%, respectively. After 6 months of treatment with efSITT, the proportion of patients with a poor treatment adherence score decreased to 20.1%, while the proportion of patients with a medium treatment adherence score increased to 34.2% and the proportion of patients with a good treatment adherence score did not change. 42% of the patients with a poor or medium treatment adherence score at baseline improved to a higher treatment adherence category, and therefore were considered as responders (p<0.0001, chi-squared test).

Conclusions Our data demonstrate a significant improvement in treatment adherence in patients with moderate to severe asthma 6 months after switch from ICS/LABA or ICS/LABA/LAMA to efSITT with BDP/FF/G (87/5/9 µg) in a real-world setting in Germany.

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Artikel online veröffentlicht:
09. März 2023