Impact of inhaled fluticasone propionate/salmeterol on health-related quality of life in asthma: A network meta-analysis
Issued Date
2022-11-01
Resource Type
ISSN
09546111
eISSN
15323064
Scopus ID
2-s2.0-85140274294
Pubmed ID
36257125
Journal Title
Respiratory Medicine
Volume
203
Rights Holder(s)
SCOPUS
Bibliographic Citation
Respiratory Medicine Vol.203 (2022)
Suggested Citation
Maneechotesuwan K., Singh D., Fritscher L.G., Dursunoglu N., Abhijith P.G., Phansalkar A., Aggarwal B., Pizzichini E., Chorazy J., Burnett H. Impact of inhaled fluticasone propionate/salmeterol on health-related quality of life in asthma: A network meta-analysis. Respiratory Medicine Vol.203 (2022). doi:10.1016/j.rmed.2022.106993 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85414
Title
Impact of inhaled fluticasone propionate/salmeterol on health-related quality of life in asthma: A network meta-analysis
Other Contributor(s)
Abstract
Objective: This network meta-analysis (NMA) compared fixed-dose, twice daily fluticasone propionate/salmeterol (FP/Sal) vs. inhaled corticosteroid (ICS) and other ICS/long-acting beta-agonists (LABA) treatments, including when administered using maintenance and reliever therapy (MART) regimens, in terms of improvements in health-related quality of life (HRQoL). The relationship between changes in asthma control and HRQoL was assessed. Methods: Articles published between 2001 and 2021, reporting change from baseline (CFB) in Asthma Quality of Life Questionnaire (AQLQ) in patients with moderate-to-severe asthma, were identified by a systematic review. Random effects Bayesian NMAs derived estimates of the mean difference in CFB in AQLQ vs. other interventions connected to the network (included 15 studies). Sensitivity analyses explored the impacts of differences in follow-up duration, baseline asthma control, the inclusion of observational studies, adjusting for baseline FEV1, and low-medium ICS dose arms only. Linear regression analysis compared CFBs in AQLQ and Asthma Control Questionnaire (ACQ) score. Results: Mean CFB in AQLQ with FP/Sal vs. comparators demonstrated expected ranked effects: mean difference 0.65 [95% credible interval: 0.54, 0.78] versus placebo, 0.58 [ 0.33, 0.84] versus LABA, 0.21 [ 0.13, 0.31] versus ICS alone, 0.06 [−0.04, 0.19] versus other ICS/LABA, and 0.00 [−0.13, 0.14] versus ICS/formoterol MART. Sensitivity analyses largely showed consistent results. Improvements in AQLQ and ACQ were strongly correlated (R = 0.94). Conclusions: This NMA demonstrates that HRQoL is responsive to treatment, is strongly related to asthma control and that it can be well-managed in patients with moderate-to-severe asthma using regular treatment with inhaled FP/Sal.