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Fixed-dose combination fluticasone/formoterol for asthma treatment in a real-world setting: meta-analysis of exacerbation rates and asthma control. | LitMetric

AI Article Synopsis

  • The treatment guidelines for asthma are often based on controlled trials, which may not represent real-world effectiveness.
  • A meta-analysis was conducted, including five observational studies with 4,756 asthma patients using fluticasone propionate/formoterol (FP/FORM).
  • The analysis revealed a severe asthma exacerbation rate of 11.47%, with FP/FORM significantly improving asthma control compared to previous conditions, demonstrating its effectiveness outside of clinical trials.

Article Abstract

Background: Treatment guidelines for asthma management are derived almost exclusively from the results of controlled clinical trials undertaken in carefully selected patient populations; meaning that their outcomes may not reflect the true performance of treatments when used in general daily medical practice. The aim of this meta-analysis was to combine the results of observational studies investigating the fluticasone propionate/formoterol (FP/FORM) fixed-dose combination in real-world asthma patients.

Methods: A systemic literature review was completed in March 2019 using the PubMed database. We identified 394 studies. Five studies, which included a total of 4756 patients treated with FP/FORM, were judged eligible and included in the meta-analysis.

Results: The estimated severe asthma exacerbation rate was 11.47% (95% CI, 5.8 to 18.72%), calculated from the random effect model. A sensitivity analysis excluding 2 studies (one was an outlier, and the exacerbation rate for the studied treatment alone could not be determined in the other) showed a 7.04% rate of severe asthma exacerbations. The estimated relative risk of the incidence of severe asthma exacerbations was 0.323 (95% CI, 0.159 to 0.658). The estimated asthma control rate was 60.6% (95% CI, 55.7% to 65.6%). The odds of achieving asthma control significantly increased by FP/FORM compared with pre-study conditions (estimated odds ratio: 2.214 [95% CI, 1.292 to 3.795];  < 0.001).

Conclusions: The findings of this meta-analysis confirm the effectiveness of FP/FORM for the treatment of asthma patients in a real-world setting beyond the limitations of RCTs.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930770PMC
http://dx.doi.org/10.1080/20018525.2023.2174642DOI Listing

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