B29-24 Baseline Characteristics and Follow-up Exacerbation Rates in Patients With Asthma Using Albuterol-Budesonide Versus Albuterol Rescue Therapy: A Retrospective Cohort Study in the United States

Rationale Asthma affects 25 million people in the US, with many experiencing exacerbations despite treatment. Airsupra™, an approved inhaled albuterol-budesonide combination, has demonstrated marked reduction in exacerbation risk compared to albuterol in trials, but real-world data are lacking. The GRANITE study compares real-world effectiveness of Airsupra versus albuterol among US adults prescribed rescue therapy. Methods This retrospective cohort study used US multi-payer insurance closed claims data (Komodo Research Data) to identify adults (≥18 years) with asthma who switched from albuterol to Airsupra between January 2023 and August 2024. Comparators for Airsupra initiators were selected by exact 1:10 matching on exacerbation history and baseline GINA step, aligning baseline risk for these key factors. Patients were followed from index date (Airsupra initiation date; eligible albuterol prescription date) until treatment switch, disenrollment, death, or study end (December 2024). Annualized rate of severe asthma exacerbation, defined as hospitalization for asthma, or an emergency/outpatient visit for asthma associated with systemic corticosteroids treatment within seven days, was calculated. Results A total of 6,154 patients met eligibility criteria and were matched to 61,540 patients taking albuterol. At baseline, the Airsupra patients were slightly younger (mean age 46.2 vs 48.6 years) and more likely to be from the South (40.7% vs 24.6%), while the albuterol cohort included greater proportions of Hispanic (13.6% vs 10.0%) and Black or African American patients (16.7% vs 9.9%); sex distribution was similar (female: 65.8% vs 64.9%). The mean (SD) follow-up duration was 4.9 (3) months for Airsupra and 6.7 (2.6) months for the albuterol cohort. Severe asthma exacerbation rates per patient-year (PPY) were lower with Airsupra [0.32 (0.29-0.34)] compared to albuterol [0.43 (0.43-0.44)], with consistently lower rates across all GINA steps during follow-up. The largest difference was observed in patients with mild asthma (GINA Step 2), with a rate of 0.18 PPY (0.14-0.24) among Airsupra initiators versus 0.30 PPY (0.29-0.32; N = 767 vs 7,670) for albuterol. In patients with severe asthma (GINA step 5) the exacerbation rates were also lower with Airsupra at 0.43 PPY (0.39-0.47) versus albuterol at 0.56 PPY (0.55-0.57; N = 2,742 vs 27,420). Conclusions This interim analysis shows that Airsupra is associated with lower asthma exacerbation rates than albuterol across all levels of disease severity in US adults prescribed rescue therapy. Ongoing analysis using propensity score weighting and longer follow-up duration will further clarify and strengthen the comparative effectiveness findings for Airsupra. Sponsorship statement The study was funded by AstraZeneca.