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Experts Reach Agreement on the Most Important Attributes of Combination Therapies for Asthma.

- The Agreement Will Provide Physicians With Much Needed Guidance for Choosing the Best Combination Therapy for Their Asthma Patients

CAMBRIDGE, England, December 6, 2010 /PRNewswire/ -- Data presented today at the World Allergy Organization (WAO WAO World Allergy Organization
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) International Conference have shown that: clinical efficacy, safety, tolerability and speed of onset of a long-acting Beta2-agonist (LABA LABA Libera Accademia Belle Arti
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LABA Long-Acting Beta-Agonist
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), potency of an inhaled corticosteroid corticosteroid /cor·ti·co·ster·oid/ (-ster´oid) any of the steroids elaborated by the adrenal cortex (excluding the sex hormones) or any synthetic equivalents; divided into two major groups, the glucocorticoids and  (ICS (1) (Internet Connection Sharing) A Windows feature that enables two or more computers to share one Internet connection. First introduced in Windows 98 Second Edition, sharing is accomplished with network address translation (NAT), which is the common method. ), and flexibility of dosing are the most important attributes that influence an expert's choice of a combination therapy to treat asthma.[1] This study, undertaken under the auspices of the Global Allergy and Asthma European Network (GA2LEN (Low Entry Networking) In SNA, peer-to-peer connectivity between adjacent Type 2.1 nodes, such as PCs, workstations and minicomputers. LU 6.2 sessions are supported across LEN connections. ), used the Delphi process, a validated consensus-development methodology that enables a group of experts to deal with a complex problem through rounds of structured feedback.

"Given the lack of clear guidelines on selecting a specific ICS/LABA therapy for asthma and the absence of conclusive evidence CONCLUSIVE EVIDENCE. That which cannot be contradicted by any other evidence,; for example, a record, unless impeached for fraud, is conclusive evidence between the parties. 3 Bouv. Inst. n. 3061-62.  supporting differences in clinical efficacy between the available combinations, this consensus has the potential to provide physicians with better direction and confidence when choosing the best option for their patients," commented Professor David Price, Centre of Academic Primary Care, University of Aberdeen The University of Aberdeen is an ancient university founded in 1495, in Old Aberdeen, Scotland and a world-renowned centre for teaching and research. It is the fifth oldest university in the United Kingdom and the wider English-speaking world. , UK.

According to this study, the factors considered to be the most important in the selection of a combination therapy as part of a stepped approach to asthma management were ranked in the following order: flexibility of dosing (88% agreement), long-term safety of the ICS and LABA (81%), clinical efficacy (81%), LABA speed of onset (69%) and ICS potency (69%).[1],[2]

The findings from another study, presented at the WAO congress, support the results from the Delphi process by indicating similar attributes of combinations are important to physicians.[2] This attitudinal study, which looked at the views of over 1,000 respiratory specialists and primary care physicians, from 13 EU countries, in real-life practice identified the symptom improvement (71%) and ICS potency (55%) as the most important attributes, followed by improvement in fixed expiratory ex·pi·ra·to·ry
adj.
Of, relating to, or involving the expiration of air from the lungs.



expiratory

relating to or employed in the expiration of air from the lungs.
 volume in 1 second (FEV FEV forced expiratory volume.

FEV
abbr.
forced expiratory volume



FEV

forced expiratory volume.
1; 50%), safety and tolerability (43%), speed of onset (42%), flexibility of dosing (40%) and duration of action (37%).[2]

A further study, presented at the WAO conference, showed an increasing trend in the prescribing of fixed combinations of an ICS and a LABA over the period 2004-2009 whereas there was a slight decline in the prescribing of ICSs alone or in free combination with a LABA over the same period.[3] The study found that overall fluticasone was the most widely prescribed ICS in Europe and the most widely prescribed ICS in fixed dose combination A fixed dose combination (FDC) is a formulation of two or more active ingredients combined in a single dosage form available in certain fixed doses. Fixed dose combination drug products may improve medication compliance by reducing the pill burden of patients.  inhalers.[3]

All studies were supported by investment from Mundipharma. "Mundipharma's support for these studies shows its commitment and investment in research which will inform the development of better treatment strategies in asthma and ultimately lead to reducing the individual and societal burden of this debilitating condition," said Professor Dr. Karen Reimer, European R&D Director at Mundipharma.

Notes to editors

About the studies presented at WAO

Combination therapy for asthma: Delphi process

GA2LEN undertook a Delphi process in order to reach agreement on which factors are considered to be the most important to take into account when choosing an ICS/LABA combination for asthma. Thirty-two experts from 9 European countries (Austria, Finland, France, Germany, Italy, Spain, Sweden, Switzerland and the UK) were invited to participate. Three rounds of structured feedback were considered in this Delphi process.

Pan-European attitudinal survey

Based on the responses of the Delphi consensus group, an attitudinal questionnaire was developed, translated and pilot-tested in face-to-face interviews. Computer-assisted web interviews were then conducted in 13 European countries. Of 1861 respondents, 1007 (54%) were eligible for inclusion; 85% of eligible respondents were respiratory specialists and 15% were primary physicians with a special interest in asthma, treating a mean of 59 asthma patients per month. Half (50%) of the patients with asthma were being treated with ICS/LABA fixed combinations, 15% with ICS alone, 10% with ICS/LABA free combinations, 10% with short-acting Beta2-agonists alone, other therapy (10%) and 5% with LABAs alone.

Trends in prescribing inhaled corticosteroids alone and in combination with long-acting Beta2-agonists in Europe in 2004-2009

The study gathered information on the retail prescribing of ICSs and LABAs in 12 European countries (Austria, Denmark, Finland, France, Germany, Ireland, Italy, Netherlands, Spain, Sweden, Switzerland and UK) between Q4 2004 and Q3 2009. For each formulation of each treatment, the number of actuations was converted to the number of inhalers prescribed.

About Mundipharma

The Mundipharma / Napp / Norpharma independent associated companies, are privately owned companies and joint ventures covering the world's pharmaceutical markets. The companies worldwide are dedicated to bringing to patients with severe and debilitating diseases the benefits of novel treatment options in fields such as rheumatoid arthritis, moderate to severe pain, haemato-oncology and respiratory disease.

For more information: http://www.mundipharma.co.uk

References:

1. Price D, Bousquet J. Combination therapy for asthma: results of a Delphi process. Abstract presented at World Allergy Organization (WAO) International Conference in Dubai, 5-8 December 2010

2. Price D. Choosing combination therapy for asthma: results of a pan-European attitudinal survey. Abstract presented at World Allergy Organization (WAO) International Conference in Dubai, 5-8 December 2010

3. Price D. Trends in prescribing inhaled corticosteroids alone and in combination with long-acting Beta2-agonists in Europe in 2004-2009. Abstract presented at World Allergy Organization (WAO) International Conference in Dubai, 5-8 December 2010
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Publication:PR Newswire Europe
Geographic Code:4EUUK
Date:Dec 6, 2010
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