Despite adherence to inhaled corticosteroid/long-acting β-agonist (ICS/LABA) therapy, many patients with asthma experience moderate exacerbations. Data on the impact of moderate exacerbations on the healthcare system are limited. This study assessed the frequency and economic burden of moderate exacerbations in patients receiving ICS/LABA. Retrospective, longitudinal study analyzed data from Optum's de-identified Clinformatics® Data Mart Database recorded between October 1, 2015, and December 31, 2019. Eligibility criteria included patients ≥18 years of age with ≥1 ICS/LABA claim and ≥1 medical claim for asthma in the 12 months pre-index (first ICS/LABA claim). Primary objectives included describing moderate exacerbation frequency, and associated healthcare resource utilization (HRU) and costs. A secondary objective was assessing the relationship between moderate exacerbations and subsequent risk of severe exacerbations. Patients were stratified by moderate exacerbation frequency in the 12 months post index. Moderate exacerbations were identified using a newly developed algorithm. In the first 12 months post index 61.6% of patients experienced ≥1 moderate exacerbation. Mean number of asthma-related visits was 4.1 per person/year and median total asthma-related costs was $3544. HRU and costs increased with increasing exacerbation frequency. Outpatient and inpatient visits accounted for a similar proportion of these costs. Moderate exacerbations were associated with an increased rate and risk of future severe exacerbations (incidence rate ratio, 1.56; hazard ratio, 1.51 [both < 0.001]). This study highlighted that a high proportion of patients continue to experience moderate exacerbations despite ICS/LABA therapy and subsequently experience increased economic burden and risk of future severe exacerbations.

中文翻译：

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吸入皮质类固醇/长效β受体激动剂治疗的哮喘患者恶化的频率和经济负担：一项回顾性美国索赔研究

尽管坚持吸入皮质类固醇/长效β受体激动剂（ICS/LABA）治疗，许多哮喘患者仍出现中度恶化。关于中度恶化对医疗保健系统影响的数据有限。本研究评估了接受 ICS/LABA 的患者中度恶化的频率和经济负担。回顾性纵向研究分析了 Optum 去识别化的 Clinformatics® 数据集市数据库在 2015 年 10 月 1 日至 2019 年 12 月 31 日期间记录的数据。资格标准包括年龄≥18 岁、有 ≥1 个 ICS/LABA 索赔和 ≥1 个医疗索赔的患者指数前 12 个月内的哮喘（第一个 ICS/LABA 索赔）。主要目标包括描述中度恶化频率以及相关的医疗资源利用 (HRU) 和成本。次要目标是评估中度恶化与随后的严重恶化风险之间的关系。根据指数后 12 个月内的中度恶化频率对患者进行分层。使用新开发的算法识别出中度恶化。在指数发布后的前 12 个月内，61.6% 的患者经历了 ≥1 次中度恶化。哮喘相关就诊平均次数为每人每年 4.1 次，哮喘相关总费用中位数为 3544 美元。 HRU 和费用随着恶化频率的增加而增加。门诊和住院就诊占这些费用的比例相似。中度恶化与未来严重恶化的发生率和风险增加相关（发病率比，1.56；风险比，1.51 [均< 0.001]）。这项研究强调，尽管接受了 ICS/LABA 治疗，仍有很大一部分患者继续经历中度病情加重，并随后经历了更大的经济负担和未来严重病情加重的风险。