title: Rates of asthma attacks in patients with previously inadequately controlled mild asthma treated in clinical practice with combination drug therapy: an exploratory post-hoc analysis.
abstract: BACKGROUND
  Differences could exist in the likelihood of asthma attacks in patients treated with inhaled corticosteroid (ICS), long-acting beta-agonist (LABA), and montelukast (MON) (ICS/LABA/MON) and patients treated with an inhaled corticosteroid (ICS) and montelukast (MON) (ICS/MON).
  
  
  METHODS
  This was a post-hoc analysis of a pretest-posttest retrospective cohort study. Patients with mild persistent asthma and allergic rhinitis, who were taking an ICS either alone or in combination with a LABA, started concomitant MON treatment as part of their routine care. Rates of asthma- and allergic rhinitis-related medical resource use in the 12-months after the initial (index) MON prescription were compared in the ICS/MON and ICS/LABA/MON groups. An asthma attack was defined as an asthma-related hospitalization, ER visit, or use of an oral corticosteroid.
  
  
  RESULTS
  Of the total of 344 patients, 181 (53%) received ICS/MON and 163 (47%) received ICS/LABA/MON in the post-index period for means of 10.5 and 11.4 months, respectively, (P < 0.05). Short-acting beta-agonists were used by 74.6% in the ICS/MON and 71.8% in the ICS/LABA/MON groups (P > 0.05). An asthma attack occurred in 4.4% of the ICS/MON group and 6.8% of the ICS/LABA/MON group (P > 0.05). The adjusted odds of an asthma attack in the post-index period in the ICS/LABA/MON group relative to the ICS/MON group was 1.24, 95% confidence interval 0.35-4.44.
  
  
  CONCLUSIONS
  In this observational study of combination drug treatment of mild persistent asthma and allergic rhinitis, no difference was observed between LABA/ICS/MON combination therapy and the ICS/MON combination without LABA use, for the rate of asthma attacks over one year.
authors.affiliation: Bussolengo Gen. Hospital, Verona, Italy. rdalnegro@ulss22.ven.it
authors.forename: Robert W
authors.initials: RW
authors.lastname: Dal Negro
authors.forename: Luis
authors.initials: L
authors.lastname: Borderias
authors.forename: Qiaoyi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Tao
authors.initials: T
authors.lastname: Fan
authors.forename: Vasilisa
authors.initials: V
authors.lastname: Sazonov
authors.forename: Magda
authors.initials: M
authors.lastname: Guilera
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Taylor