A32-09 Beclometasone/Formoterol (BDP/FF) Is Non-inferior to Budesonide/Formoterol (BUD/FF) as Maintenance and Reliever Therapy (MART) and Reduces Inhaler-related GHG Emissions in Adult Asthma

Introduction/Aim No direct comparison exists between the two maintenance and reliever therapy (MART) regimens for asthma. This study evaluated whether BDP/FF-MART is not inferior to BUD/FF-MART in preventing exacerbations, or controlling asthma, and assesses the carbon footprint of inhalers after initiating BDP/FF-MART. Method This historical cohort study used the UK Optimum Patient Care Research Database to compare adults (≥18 years, ≥12 months baseline data) with asthma who started BDP/FF-MART or BUD/FF-MART between July 2012 and November 2024. A sensitivity analysis, which forms the basis of this abstract, included patients prescribed SABA within 3 months of MART initiation, reflecting inappropriate clinical practice. Groups were balanced by inverse probability weighting. Outcomes over 12 months were analysed using negative binomial regression for exacerbations and logistic regression for asthma control, with non-inferiority margins set at 10% and 15%. Carbon footprint per inhaler was estimated from published CO2 data and life cycle assessments (exploratory). Results In this sensitivity analysis cohort,of the 63,966 patients, 66% initiated BDP/FF-MART and 34% BUD/FF-MART. BDP/FF-MART was non-inferior to BUD/FF-MART for exacerbations (IRR: 0.98 [95% CI: 0.93, 1.04]) and asthma control (OR: 0.92 [95% CI: 0.88, 0.96]). Both BDP/FF-MART and BUD/FF-MART demonstrated meaningful improvements in asthma control and exacerbation reduction, reinforcing the effectiveness of MART even in adults who continue to use SABA with MART. Mean carbon footprint per person lowered after BDP/FF-MART (pre- vs post-: min: 87 vs 85 kg CO2 eq; max: 179 vs 159), with a reduction in SABA usage by 25–31%. Conclusion The results from the sensitivity analysis confirmed that BDP/FF-MART was non-inferior to BUD/FF-MART for severe exacerbations and asthma control, with or without SABA use in the first 3 months and reduced the total carbon footprint of inhaler-related GHG emissions. Grant Support The study is funded by the Observational & Pragmatic Research Institute (OPRI) and Chiesi (Australia).