OBJECTIVES : Triple therapy (TT) consisting of long-acting beta-agonists (LABA), long-acting muscarinic antagonists (LAMA) and inhaled corticosteroids (ICS) is currently administered via multiple inhalers (MI) and is a guideline recommended approach for asthmatic patients. However, data about patient profile and use in real-life practice is scarce.

The aim of this study is to describe the profile of asthmatic patients who initiate TT, the treatment pathway (12 months before and after initiation) and treatment adherence.

METHODS : This retrospective study used the SIDIAP database (Information System for Research in Primary Care) of Cataluña. Patients 18-75 years old with a diagnosis of asthma who initiated TT in 2016 were included. Prescription and overlap of ≥60 days of each of the 3 components (LABA+LAMA+ICS) were defined as TT.

RESULTS : In the cohort of 1,204 patients on TT, 70.7% women and mean age of initiation of 54.83 years, mean FEV₁ was 70.77% and a value of 4.06% of eosinophils in peripheral blood. In the 12 months prior to TT initiation, 55.4% had ≥1 exacerbation, 42.9% were on ICS+LABA and 25.5% had also antileukotrienes.

37.4% discontinued in the 12 months post period. Only 16.3% had a good rate of adherence (>80% of days covered). Greater adherence was associated with older age at TT initiation, presenting anxiety-depression, a sick leave due to respiratory cause and previous ICS/LABA treatment.

CONCLUSIONS : Given the significant proportion of patients who discontinue and the low adherence rate, it seems that identifying factors leading to discontinuation such as complex dosing regimen could be beneficial for these patients.

Funding: GSK (HO-18-18550)