D3.139 - Asthma control and medication adherence in patients with asthma using preferred versus alternative GINA treatment tracks - a real-world observational study

GINA recommends ICS/formoterol-based regimens as the preferred treatment approach for adults. However, real-world comparative data between preferred and alternative treatment strategies remain limited. This study aims to assess asthma control and medication adherence among adult patients with asthma treated with budesonide/formoterol as maintenance-and-reliever therapy (MART) versus fluticasone furoate/vilanterol (FF/VI) in a real-world clinical setting.

A cross-sectional study conducted at an Allergy and Clinical Immunology Department of a tertiary hospital in Lisbon, Portugal. Adult patients with a diagnosis of asthma (A2 scale) treated with budesonide/formoterol or FF/VI were included. Data on sex, age, body mass index, allergen sensitization, smoking habits, asthma severity (GINA 2025), asthma control (ACT), reliever therapy use (<2x/week vs ≥2x/week), medication adherence (Treatment Adherence Measure [MAT]) and lung function parameters were collected.

A total of 123 patients were included, predominantly female (n=88; 71.5%), with a median age of 28 years (IQR 21), all classified as GINA treatment step 3 (n=98; 79.7%) or 4 (n=25; 20.3%). Overall,84 patients (68.3%) were treated with budesonide/formoterol as MART and 39 (31.7%) with FF/VI. No statistically significant differences were observed between treatment groups in asthma control, rescue medication use, medication adherence, and lung function. Although not statistically significant, FF/VI showed a trend toward higher asthma control (87.2% vs 72.6%; OR 2.56; 95% CI 0.89–7.36; p=0.073) and lower rescue medication use (10.3% vs 25.0%; OR 0.34; 95% CI 0.11–1.08; p=0.059). Among patients treated with budesonide/formoterol, no differences were observed according to the inhaler device used.

Despite GINA guideline preference for ICS/formoterol-based regimens, no significant differences in asthma control, rescue medication use, medication adherence or lung function were observed between FF/VI and budesonide/formoterol as MART in our sample. These findings support individualized treatment selection and highlight the need for larger real-world comparative studies.