Greater adherence in montelukast patients compared to those on fluticasone

• Published in: Journal of allergy and clinical immunology Vol. 113; no. 2; p. S158
• Main Authors: Allen-Ramey, F.C., Anstatt, D.T., Riedel, A.A., Markson, L.E.
• Format: Journal Article
• Language: English
• Published: St. Louis Mosby, Inc 01.02.2004; Elsevier Limited
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2003.12.580

To examine adherence and persistence with tablet montelukast and inhaled fluticasone among pediatric and adult asthmatics. A U.S. managed care claims database was used to compare adherence and persistence to asthma controller therapy. Patients aged 2-55 years initiating montelukast sodium tablet (MON) or inhaled fluticasone propionate (FP) between 01/01/99-06/30/00 (index prescription) were identified. MON and FP patients were matched by age and propensity score using baseline characteristics. Adherence to controller was measured using average number of refills and total days supply over a 12 month period; treatment groups were compared using Wilcoxon rank sum test. Persistence was measured as percent of patients with evidence of continued controller use at 6- and 12-month follow-up; treatment groups were compared using relative risks. 6,160 individuals (3,080 per treatment group) were identified - 2-5 year-old group (n=496), 6-14 year-old group (N=1,538) and 15-55 year-old group (N=4,126). Greater refills per patient were observed among MON patients versus FP patients for those 2-5 years (MON:4.8, FP:2.7, p<.001), 6-14 years (MON:4.2, FP:2.1, p<.001) and 15-55 years (MON:4.5, FP:2.2, p<.001). MON patients had greater days supply of medication in the post-index period versus FP patients across all age groups (p<.001). Persistence at 6 months among MON users was higher than FP users for patients 2-5 years (RR: 1.46, 95% CI:1.15,1.87), 6-14 years (RR:2.14, 95% CI:1.80,2.53) and 15-55 years (RR:2.12, 95% CI:1.92,2.35); similar patterns were observed at 12 months. This study of pediatric and adult asthmatics found greater adherence and persistence to therapy with MON tablet versus inhaled FP.