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- W2011494383 abstract "RATIONALE: This study identifies risk factors for asthma exacerbations in children/adolescents receiving MON monotherapy who stepped up to either an ICS or ICSLABA. METHODS: Eligible subjects from the Ingenix LabRx database included asthmatics (2-18 years) who started MON during 2004-2006, then stepped up to an ICS or ICSLABA within one year. Occurrence of any asthma exacerbation (ER use, inpatient stay, office-based SABA administration, oral steroid use, or high use of SABA [>2 canisters/nebule-equivalents]) was tracked one year after step-up (index-event). Logistic regression models (backwards elimination [p=0.25]) were run separately for ages 2-5, 6-11, 12-18 years. Risk factors included ICSLABA vs. ICS, demographics, provider specialty, enrollment-length, propensity to receive ICSLABA vs. ICS, one-year pre-ICS/ICSLABA experience/conditions and time/adherence on MON therapy. RESULTS: 36% of 2,620 eligible subjects (n=1,782 ICS, n=838 ICSLABA) experienced a post-ICS/ICSLABA exacerbation. Each model eliminated ICSLABA vs. ICS use as a risk factor. For ages 2-5, significant risk factors included high pre-index SABA use (OR=2.27, p=0.001) and oral steroid use (OR=1.57, p=0.002). For ages 6-11, significant factors were high pre-index SABA use (OR=2.08, p<0.001), summer start-date for ICS/ICSLABA (OR=1.59, p=0.008), prior exacerbation-office-visit (OR=1.58, p=0.015), enrollment length[days] (OR=0.9994, p=0.012) and family practice (OR=1.50, p=0.04). For ages 12-18, significant factors were prior asthma in-patient (OR=4.53, p=0.020), high pre-index SABA use (OR=3.69, p<0.001), pulmonologist (OR=2.89, p=0.034), and prior exacerbation-office-visit (OR=1.70, p=0.038). CONCLUSIONS: Use of ICSLABA vs. ICS was not associated with a reduction in exacerbation risk. High SABA use and history of exacerbations prior to ICS/ICSLABA step-up remain strong predictors for exacerbations in the post-ICS/ICSLABA year." @default.
- W2011494383 created "2016-06-24" @default.
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- W2011494383 date "2010-02-01" @default.
- W2011494383 modified "2023-10-15" @default.
- W2011494383 title "Risk Factors for Exacerbations in Pediatric Asthmatic Patients Receiving Montelukast Monotherapy (MON) Who Step Up to an Inhaled Corticosteriod (ICS) or a Fixed-Dose Combination of ICS and Long-Acting Beta Agonist (ICSLABA)" @default.
- W2011494383 doi "https://doi.org/10.1016/j.jaci.2009.12.668" @default.
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