Exacerbation Reduction in Patients with Asthma Following Escalation to FF/UMEC/VI from ICS/LABA: Retrospective Cohort Study
Bibliographic record
Abstract
Despite fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) being available for asthma treatment in the US (United states) since 2020, real-world evidence on its clinical and economic benefits in patients with asthma is lacking. This study aimed to assess the effectiveness of FF/UMEC/VI (100/62.5/25 µg and 200/62.5/25 µg) in US patients with asthma previously on inhaled corticosteroid/long-acting β 2 -agonists (ICS/LABA) using administrative claims data. Retrospective, longitudinal, pre-post study utilizing data from the Komodo Health database between 09/09/2019 and 12/31/2023. Eligible adults with asthma had been treated with ICS/LABA prior to FF/UMEC/VI initiation (index date: first FF/UMEC/VI prescription). Rates of moderate–severe exacerbations, asthma-related healthcare resource utilization, oral corticosteroid (OCS) and short-acting β 2 -agonist (SABA) use, and asthma-related medical costs were evaluated pre- (12 months pre-index) and post-FF/UMEC/VI initiation (12 months post-index). Statistical analyses involved rate ratios (RRs) from a Poisson regression model, odds ratios (ORs) from logistic regression models, and mean differences from linear regression models. Exploratory analyses stratified these results by pre-index ICS/LABA combination and FF/UMEC/VI index dose. In total, 17,959 patients were included. Following FF/UMEC/VI initiation, odds of having ≥ 1 exacerbation were reduced by 52% (OR [95% confidence interval (CI)] 0.48 [0.46, 0.50]; P < 0.001), rate of moderate–severe exacerbations reduced by 38% (RR [95% CI] 0.62 [0.61, 0.64]; P < 0.001) and asthma-related hospitalizations by 25% (RR [95% CI] 0.75 [0.68, 0.83]; P < 0.001). Odds of ≥ 1 OCS dispensing were reduced by 36% (OR [95% CI] 0.64 [0.62, 0.67]; P < 0.001) and ≥ 1 SABA canister use by 54% (OR [95% CI]: 0.46 [0.44, 0.48]; P < 0.001) post initiation; mean annualized asthma-related medical costs were reduced by $1115 ([95% CI] [$ −1771, $ −459]; P < 0.001). Both FF/UMEC/VI dosage groups had similar results. In patients who remain uncontrolled despite ICS/LABA treatment, escalating to FF/UMEC/VI is associated with reductions in asthma exacerbations, asthma-related hospitalizations, OCS use, SABA use, and asthma-related medical costs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".