Clinical Characteristics, Treatment Persistence, and Outcomes Among Patients With COPD Treated With Single- or Multiple-Inhaler Triple Therapy: A Retrospective Analysis in Spain

Comparison of treatment persistence, adherence, and risk of exacerbation in patients with COPD treated with single-inhaler versus multiple-inhaler triple therapy: A prospective observational study in China

“…Our results also showed that persistence at 12 months for the entire study population was 63.6% and that COPD patients in the SITT group had a higher persistence rate than those in the MITT group. This was in keeping with the published results in which the persistence at 12 months for all patients was 62.7%, and a higher persistence rate was also found in the SITT than in the MITT cohort ( Alcázar-Navarrete et al, 2022 ). These two studies both use a treatment gap of no more than 60 days to define treatment persistence for COPD.…”

“…This study found that patients in the SITT group had a significantly lower median number of exacerbations, a lower proportion of patients with ≥1 exacerbation, and severe but frequent exacerbations during the 1-year follow-up in COPD. This is in accordance with an observational study in Spain which found that patients with COPD in the SITT cohort had a lower median number of exacerbations and lower incidence of moderate-to-severe future exacerbation and all-cause mortality than the MITT cohort during the 12-month follow-up ( Alcázar-Navarrete et al, 2022 ). Furthermore, after adjusting for differences in persistence and other variables in multivariate Cox analysis, the study showed that SITT led to a risk reduction in moderate-to-severe and severe exacerbation during the follow-up, compared with the MITT group.…”

“…Furthermore, after adjusting for differences in persistence and other variables in multivariate Cox analysis, the study showed that SITT led to a risk reduction in moderate-to-severe and severe exacerbation during the follow-up, compared with the MITT group. However, previous studies have shown that SITT can enhance symptom improvement in a European 24-week multicenter, randomized, open-label, phase IV effectiveness study (INTREPID) ( Halpin et al, 2021b ) and reduce the risk of future exacerbation and mortality, but this was not adjusted for differences in treatment persistence ( Alcázar-Navarrete et al, 2022 ). The present study was the first to show that SITT could still decrease the risk of exacerbations and mortality over MITT after adjusting for differences in persistence.…”

“…Non-persistence (discontinuation) was defined as >60 days without using SITT or MITT, otherwise defined as persistence. The persistence rate is the proportion of patients who obtain persistence at 6 or 12 months ( Alcázar-Navarrete et al, 2022 ; Mannino et al, 2022 ). The study also recorded the incidence of moderate-to-severe exacerbation during the 1-year follow-up period.…”

“…However, a real-world observational study in the United Kingdom showed that patients with SITT had improved lung function and a higher proportion of CAT improvement at 24 weeks compared with the MITT group ( Halpin et al, 2021b ). Furthermore, only a retrospective cohort study in Spain showed that SITT was related to a lower risk of exacerbation and lower medical treatment costs ( Alcázar-Navarrete et al, 2022 ).…”