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The carbon footprint of as-needed budesonide/formoterol in mild asthma: a post hoc analysis.
Hatter, Lee; Holliday, Mark; Eathorne, Allie; Bruce, Pepa; Pavord, Ian D; Reddel, Helen K; Hancox, Robert J; Papi, Alberto; Weatherall, Mark; Beasley, Richard.
Afiliação
  • Hatter L; Medical Research Institute of New Zealand, Wellington, New Zealand lee.hatter@mrinz.ac.nz.
  • Holliday M; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
  • Eathorne A; Medical Research Institute of New Zealand, Wellington, New Zealand.
  • Bruce P; Medical Research Institute of New Zealand, Wellington, New Zealand.
  • Pavord ID; Medical Research Institute of New Zealand, Wellington, New Zealand.
  • Reddel HK; Nuffield Department of Clinical Medicine and Oxford Respiratory NIHR BRC, University of Oxford, Oxford, UK.
  • Hancox RJ; Woolcock Institute of Medical Research and Macquarie University, Sydney, Australia.
  • Papi A; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
  • Weatherall M; Sydney Local Health District, Sydney, Australia.
  • Beasley R; Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Eur Respir J ; 64(1)2024 Jul.
Article em En | MEDLINE | ID: mdl-38609096
ABSTRACT

INTRODUCTION:

The use of pressurised metered-dose inhalers (pMDIs) and asthma exacerbations necessitating healthcare reviews contribute substantially to the global carbon footprint of healthcare. It is possible that a reduction in carbon footprint could be achieved by switching patients with mild asthma from salbutamol pMDI reliever-based therapy to inhaled corticosteroid-formoterol dry powder inhaler (DPI) reliever therapy, as recommended by the Global Initiative for Asthma.

METHODS:

This post hoc analysis included all 668 adult participants in the Novel START trial, who were randomised 111 to treatment with as-needed budesonide/formoterol DPI, as-needed salbutamol pMDI or maintenance budesonide DPI plus as-needed salbutamol pMDI. The primary outcome was carbon footprint of asthma management, expressed as kilograms of carbon dioxide equivalent emissions (kgCO2e) per person-year. Secondary outcomes explored the effect of baseline symptom control and adherence (maintenance budesonide DPI arm only) on carbon footprint.

RESULTS:

As-needed budesonide/formoterol DPI was associated with 95.8% and 93.6% lower carbon footprint compared with as-needed salbutamol pMDI (least-squares mean 1.1 versus 26.2 kgCO2e; difference -25.0, 95% CI -29.7 to -20.4; p<0.001) and maintenance budesonide DPI plus as-needed salbutamol pMDI (least-squares mean 1.1 versus 17.3 kgCO2e; difference -16.2, 95% CI -20.9 to -11.6; p<0.001), respectively. There was no statistically significant evidence that treatment differences in carbon footprint depended on baseline symptom control or adherence in the maintenance budesonide DPI arm.

CONCLUSIONS:

The as-needed budesonide/formoterol DPI treatment option was associated with a markedly lower carbon footprint than as-needed salbutamol pMDI and maintenance budesonide DPI plus as-needed salbutamol pMDI.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Asma / Broncodilatadores / Budesonida / Inaladores de Pó Seco / Pegada de Carbono / Fumarato de Formoterol Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Asma / Broncodilatadores / Budesonida / Inaladores de Pó Seco / Pegada de Carbono / Fumarato de Formoterol Idioma: En Ano de publicação: 2024 Tipo de documento: Article