Trends in the initial treatment of adults with asthma in the Netherlands: a population-based database study

Despite availability of asthma guidelines, little is known about the asthma treatment trends in Dutch primary care. This study aimed to analyze changes in trends in the initial therapy prescribed for adults with asthma in Dutch primary care from 2010 to 2021. Initial therapy was defined as the first prescription issued within 3 months after diagnosis, extracted from the PHARMO Data Network. Age and sex-standardized annual treatment proportions were analyzed with joinpoint regression and reported as annual percentage change. 95,523 adults with asthma were included (40% men; age 45 [IQR 31, 59] years). 35.6% had no prescription/guideline-compliant treatment. The preferred initial treatment was SABA alone (25.2%), followed by ICS/LABA (23.9%), ICS (14.5%) and ICS/LABA/LAMA (0.7%). ICS/LABA increased significantly after 2018 from 22.1% to 30.6% (12 [95%CI 8.3, 15.1]%), while SABA alone modestly decreased from 29.5% to 26.1% (−3.4 [−7.2, -1.3]%). The ICS trend changed in 2019, after which it declined (−14.9 [−20.9, -8]%). Triple therapy remained stable (2.8 [−0.9, 6.6]%) (Fig. 1). Increased use of ICS/LABA and decreased use of SABA alone in Dutch primary care represent changes in treatment trends aligned with guidelines. Nevertheless, a high proportion of patients still receive SABA-only therapy, underlying the need for continuous monitoring. <bold>Funding:</bold> This work was supported by AstraZeneca, Chiesi and TEVA <fig><object-id>erj;64/suppl_68/OA5578/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>