Characteristics and treatment pathways of patients with COPD receiving an inhaled corticosteroid/long-acting ß2-agonist (ICS/LABA) in the UK

Czira, Alexandrosz; Banks, Victoria; Requena, Gema; Wood, Robert; Tritton, Theo; Ha, Eunmi; Wild, R; Compton, Chris; Ismaila, Afisi S

doi:10.1183/13993003.congress-2021.pa2411

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“…However, as a recent study found that only approximately 10% of patients received one or more ICS- or LABA-containing medications in the 12 months prior to initiating TIO/OLO or UMEC/VI, the impact of this eligibility criteria on result generalizability is likely minimal. 25 Additionally, the generalizability of the study results to the wider UK population could be impacted by CPRD-Aurum data only covering 15% of UK practices and HES linkage reducing the patient sample to only those registered at a GP practice in England. However, as the sample population is considered highly representative of the whole UK population, 26 the results can be considered generalizable.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Rescue Medication Prescriptions in Patients with Chronic Obstructive Pulmonary Disease Receiving Umeclidinium/Vilanterol versus Tiotropium Bromide/Olodaterol in Routine Clinical Practice in England

Requena¹,

Czira²,

Banks³

et al. 2023

COPD

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Purpose Routinely collected healthcare data on the comparative effectiveness of the long-acting muscarinic antagonist/long-acting β 2 -agonist combination umeclidinium/vilanterol (UMEC/VI) versus tiotropium bromide/olodaterol (TIO/OLO) for chronic obstructive pulmonary disease (COPD) is limited. This study compared rescue medication prescriptions in patients with COPD in England receiving UMEC/VI versus TIO/OLO. Patients and Methods This retrospective cohort study used primary care data from the Clinical Practice Research Datalink Aurum database linked with secondary care administrative data from Hospital Episode Statistics. Patients with a COPD diagnosis at age ≥35 years were included (indexed) following initiation of single-inhaler UMEC/VI or TIO/OLO between July 1, 2015, and September 30, 2019. Outcomes included the number of rescue medication prescriptions at 12-months (primary), and at 6-, 18- and 24-months (secondary), adherence at 6-, 12-, 18- and 24-months post-index, defined as proportion of days covered ≥80% (secondary), and time-to-initiation of triple therapy (exploratory). Inverse probability of treatment weighting (IPTW) was used to balance potential confounding baseline characteristics. Superiority of UMEC/VI versus TIO/OLO for the primary outcome of rescue medication prescriptions was assessed using an intention-to-treat analysis with a p-value < 0.05. Results In total, 8603 patients were eligible (UMEC/VI: n = 6536; TIO/OLO: n = 2067). Following IPTW, covariates were well balanced across groups. Patients initiating UMEC/VI had statistically significantly fewer (mean [standard deviation]; p-value) rescue medication prescriptions versus TIO/OLO in both the unweighted (4.84 [4.78] vs 5.68 [5.00]; p < 0.001) and weighted comparison (4.91 [4.81] vs 5.48 [5.02]; p = 0.0032) at 12 months; consistent results were seen at all timepoints. Adherence was numerically higher for TIO/OLO versus UMEC/VI at all timepoints. Time-to-triple therapy was similar between treatment groups. Conclusion UMEC/VI was superior to TIO/OLO in reducing rescue medication prescriptions at 12 months after treatment initiation in a primary care cohort in England, potentially suggesting improvements in symptom control with UMEC/VI compared with TIO/OLO.

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Section: Discussionmentioning

confidence: 99%