Mometasone Furoate Vs Fluticasone Propionate in Mild Persistent Asthma: Retrospective Analysis of Asthma Control and Adherence

Background: Little information exists on the impact of various inhaled corticosteroids on asthma management in clinical practice. A retrospective claims analysis compared the impact of mometasone furoate (MF) and fluticasone propionate (FP) inhalers in asthma patients with no prior use of asthma controller medications. Key outcomes were asthma control (exacerbation events and short-acting β₂-agonist [SABA] use) and adherence (asthma controller medication prescription [Rx] fills).

 

Methods: Medication-naïve patients (12-65 y) with mild, persistent asthma (N=11,841) were identified (Ingenix LabRx database; Oct 2001–Dec 2007). The index event (first FP or MF Rx fill) was identified; patient demographic, drug utilization, and outcome data were collected for preindex (180 d) and postindex (365 d) periods. A 1:1 propensity score was used to match 3046 patients (1523 per cohort) on preindex demographics and utilization characteristics. Bivariate analyses were conducted to compare MF and FP cohorts.

 

Results: FP patients had significantly more exacerbations than MF patients (mean=0.21 vs 0.15, respectively; P=.0263) and more SABA fills in the postindex period (mean=1.50 vs 1.20 canisters; P<.0001). Based on Rx fills, MF patients had significantly better adherence in the postindex period than FP patients (mean=3.29 vs 2.15 fills; P<.0001).

 

Conclusions: In patients with mild, persistent asthma previously untreated with asthma controller medications, MF was associated with better asthma control than FP as evidenced by fewer exacerbations and less SABA use. Better adherence to MF may improve asthma control compared with FP.