Asthma Clinical Trial
Official title:
A Retrospective Evaluation of the Effectiveness and Cost-effectiveness of HFA-BDP MDI (Qvar®) Compared With CFC-BDP MDI and FP MDI Used in the Management of Asthma in a Representative UK UK Primary Care Population
The objective of the study was to compare the effectiveness, cost-effectiveness and direct healthcare costs of managing asthma in patients with evidence of persistent asthma, following the initiation and increased dose of inhaled corticosteroid (ICS) therapy using HFA-BDP (Qvar®) (either as initial therapy or as a step-up therapy) compared with the most commonly prescribed alternative ICS in the UK, CFC-beclometasone (BDP) and fluticasone (FP) as metered dose inhalers (MDIs). Qvar vs FP analyses were split between adults (12-60yrs) and paediatrics (5-11yrs).
While current UK asthma guidelines are underpinned with evidence from RCTs, much of this
evidence has been undertaken in patients who are not representative of the majority of the
current UK asthma population. In fact it has been estimated that fewer than 10% of the
patients seen in everyday clinical practice would be eligible for inclusion in such trials.
The poor representation of the asthma population is due to a number of factors, such as
tightly-controlled inclusion criteria for RCTs. There is therefore a need for more
representative RCTs and real-life and observational studies to inform existing guidelines
and help optimise asthma outcomes. A more holistic approach to respiratory research would
see RCT evidence complimented by "real-life" data from pragmatic trials and observational
studies.
A number of trends are emerged in asthma prescribing that warrant further investigation to
ascertain their benefit to both the patient and the NHS. In particular, significant pressure
exists to use the cheapest inhaler devices and formulations. An analysis of a pragmatic
trial of Qvar versus standard CFC-BDP undertaken by Research in Real Life suggested that
Qvar may be offer greater effectiveness in.5,6 In light of these data, the following report
details the findings of a study designed to examine the effectiveness of Qvar in real-life
clinical practice using the General Practice Research Database (GPRD).
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Observational Model: Cohort, Time Perspective: Retrospective
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