{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T17:10:04Z","timestamp":1756660204644,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"GSK","award":["207017"],"award-info":[{"award-number":["207017"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2024,2,9]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>For patients with asthma who remain symptomatic on medium-dose inhaled corticosteroid\/long-acting \u03b2<jats:sub>2<\/jats:sub>-agonist, add-on long-acting muscarinic antagonist is a treatment option, which can be administered as multiple-inhaler triple therapy (MITT). A high proportion of patients (61.5%\u201388.2%) discontinue MITT use within 1 year postinitiation; however, which patients discontinue and their treatment patterns at initiation are unknown. This study aimed to understand the demographic, clinical and treatment-related characteristics of patients with asthma who newly initiated MITT, by discontinuation status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study used administrative data from IBM Truven MarketScan Commercial Claims and Encounters Database with Medicare supplement between 1 January 2016 and 31 December 2019. Adult patients with asthma who initiated MITT between 1 January 2017 and 31 March 2019 were included and were classified based on their discontinuation status. \u2018Continuous users\u2019 had continuous use of MITT and \u2018discontinuers\u2019 discontinued treatment within the 6-month period postinitiation. Demographics and clinical characteristics, asthma treatment use prior to MITT initiation (12-month baseline period), mode of MITT initiation and complexity of regimen were described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 4132 patients (mean age: 49.0 years, 67.9% female), 78.0% (n=3224) were discontinuers; 22.0% (n=908) were continuous users. Demographic and other clinical and treatment-related characteristics during baseline were broadly similar between cohorts. A significantly higher proportion of continuous users versus discontinuers had \u22656 dispensed claims for short-acting \u03b2<jats:sub>2<\/jats:sub>-agonist canisters (16.0% vs 12.5%; p=0.006) during baseline and initiated a once-daily MITT regimen (35.2% vs 26.2%; p&lt;0.001). Fewer continuous MITT users used a mix of once-daily and twice-daily regimens than those who discontinued MITT (64.3% vs 72.3%; p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Most patients with asthma discontinued MITT within 6 months. Results indicate that patients with a history of uncontrolled, symptomatic asthma and those using less complex triple therapy regimens at initiation are less likely to discontinue MITT than patients with controlled asthma and those using a complex MITT regimen.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2023-001702","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T23:30:10Z","timestamp":1709681410000},"page":"e001702","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics, treatment patterns and burden of illness in US patients with asthma newly initiating multiple-inhaler triple therapy"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2946-4880","authenticated-orcid":false,"given":"Beade","family":"Numbere","sequence":"first","affiliation":[{"name":"R&D Global Medical, GSK, Brentford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunhao","family":"Liu","sequence":"additional","affiliation":[{"name":"R&D Global Medical, GSK, Brentford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"R&D Global Medical, GSK, Collegeville, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandrosz","family":"Czira","sequence":"additional","affiliation":[{"name":"R&D Global Medical, GSK, Brentford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifei","family":"Lu","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"2025083109361025000_11.1.e001702.1","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/S2213-2600(17)30293-X","article-title":"Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the global burden of disease study 2015","volume":"5","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2025083109361025000_11.1.e001702.2","unstructured":"Global Initiative for Asthma . Global strategy for asthma management and prevention. 2023. Available: https:\/\/ginasthma.org\/wp-content\/uploads\/2023\/07\/GINA-2023-Full-report-23_07_06-WMS.pdf"},{"key":"2025083109361025000_11.1.e001702.3","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jaip.2021.09.033","article-title":"Treatment patterns and disease burden associated with multiple-Inhaler triple-therapy use in asthma","volume":"10","author":"Oppenheimer","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2025083109361025000_11.1.e001702.4","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1080\/03007995.2020.1763937","article-title":"Clinical characteristics, treatment patterns, disease burden, and persistence\/adherence in patients with asthma initiating inhaled triple therapy: real-world evidence from Japan","volume":"36","author":"Suzuki","year":"2020","journal-title":"Curr Med Res Opin"},{"key":"2025083109361025000_11.1.e001702.5","doi-asserted-by":"crossref","unstructured":"Meeraus W , Zhang S , Fowler A , et al . Treatment patterns in English asthma patients initiating multiple inhaler triple therapy: a cohort study. ERS International Congress 2020 abstracts; September 7, 2020:2277 doi:10.1183\/13993003.congress-2020.2277","DOI":"10.1183\/13993003.congress-2020.2277"},{"key":"2025083109361025000_11.1.e001702.6","unstructured":"World Health Organization . ICD-10: International Statistical Classification of Diseases and Realted Health Problems: 10th revision, 2nd edn, Available: https:\/\/apps.who.int\/iris\/handle\/10665\/42980"},{"key":"2025083109361025000_11.1.e001702.7","unstructured":"Meeraus W , Numbere B , Liu Y , et al . Assessing algorithms to identify asthma patients using multiple inhaler triple therapy (comprising ICS, LABA, LAMA) in a real-world database. ISPOR Europe 2021, Copenhagen, Denmark. 2021. Available: https:\/\/www.ispor.org\/heor-resources\/presentations-database\/presentation\/euro2021-3409\/113734"},{"key":"2025083109361025000_11.1.e001702.8","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01872-2019","article-title":"Overuse of short-acting beta2-agonists in asthma is associated with increased risk of exacerbation and mortality: a nationwide cohort study of the global SABINA programme","volume":"55","author":"Nwaru","year":"2020","journal-title":"Eur Respir J"},{"key":"2025083109361025000_11.1.e001702.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-028995","article-title":"Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists: an Australian community pharmacy-based survey","volume":"9","author":"Azzi","year":"2019","journal-title":"BMJ Open"},{"key":"2025083109361025000_11.1.e001702.10","doi-asserted-by":"crossref","first-page":"343","DOI":"10.2147\/COPD.S184653","article-title":"Medication adherence and persistence in chronic obstructive pulmonary disease patients receiving triple therapy in a USA commercially insured population","volume":"14","author":"Bogart","year":"2019","journal-title":"Int J Chron Obstruct Pulmon Dis"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2023-001702","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T16:36:18Z","timestamp":1756658178000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2023-001702"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,3,5]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bmjresp-2023-001702"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2023-001702","relation":{},"ISSN":["2052-4439"],"issn-type":[{"type":"electronic","value":"2052-4439"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}