Improved adherence with once-daily versus twice-daily dosing of mometasone furoate administered via a dry powder inhaler: a randomized open-label study

BMC Pulm Med. 2010 Jan 5:10:1. doi: 10.1186/1471-2466-10-1.

Abstract

Background: Poor adherence with prescribed asthma medication is a major barrier to positive treatment outcomes. This study was designed to determine the effect of a once-daily administration of mometasone furoate administered via a dry powder inhaler (MF-DPI) on treatment adherence compared with a twice-daily administration.

Methods: This was a 12-week open-label study designed to mimic an actual clinical setting in patients >or=12 years old with mild-to-moderate persistent asthma. Patients were randomized to receive MF-DPI 400 microg once-daily in the evening or MF-DPI 200 microg twice-daily. Adherence was assessed primarily using the number of actual administered doses reported from the device counter divided by the number of scheduled doses. Self-reports were also used to determine adherence. Health-related quality of life, healthcare resource utilization, and days missed from work or school were also reported.

Results: 1233 patients were randomized. The mean adherence rates, as measured by the automatic dose counter, were significantly better (P < 0.001) with MF-DPI 400 microg once-daily in the evening (93.3%) than with MF-DPI 200 microg twice-daily (89.5%). Mean adherence rates based on self-reports were also significantly better (P < 0.001) with MF-DPI 400 microg QD PM (97.2%) than with MF-DPI 200 microg twice-daily (95.3%). Adherence rates were lower in adolescents (12-17 years old). Health-related quality of life improved by 20% in patients using MF-DPI once-daily in the evening and by 14% in patients using MF-DPI twice-daily. Very few (<8%) patients missed work/school.

Conclusion: Mean adherence rates were greater with a once-daily dosing regimen of MF-DPI than with a twice-daily dosing regimen.This trial was completed prior to the ISMJE requirements for trial registration.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Asthma / drug therapy*
  • Child
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Mometasone Furoate
  • Powders / administration & dosage
  • Powders / adverse effects
  • Pregnadienediols / administration & dosage*
  • Pregnadienediols / adverse effects
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Powders
  • Pregnadienediols
  • Mometasone Furoate