Real-World Treatment Patterns of Multiple-Inhaler Triple Therapy Among Patients with Chronic Obstructive Pulmonary Disease in UK General Practice

Sansbury, Leah B.; Bains, Chanchal; Lipson, David A.; Ismaila, Afisi S; Landis, Sarah H.

doi:10.2147/copd.s290773

Cited by 11 publications

(11 citation statements)

References 34 publications

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“…In other retrospective observational analyses of databases, persistence rates in users of MITT for COPD are generally low, although definitions of persistence were variable. [26][27][28] Using an allowable treatment gap of no more than 30 days, analysis of a US claims database (IQVIA Adjudicated Health Plan Claims) found that 86% of patients discontinued treatment at 12 months. 26 A UK study, which analyzed electronic health records and hospital episodes in COPD patients, found that the duration of continuous MITT use at 12 months was 23.8%.…”

Section: Resultsmentioning

confidence: 99%

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

Alcázar‐Navarrete

Jamart

Sánchez-Covisa

et al. 2022

CHEST

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Section: Resultsmentioning

confidence: 99%

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

Alcázar‐Navarrete

Jamart

Sánchez-Covisa

et al. 2022

CHEST

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“…A UK study has assessed real-world treatment patterns of MITT (initiated between 2013 and 2015) among patients with COPD (n = 3825) treated in general practice. 3 Most patients prescribed MITT had a history of clinically relevant symptoms and AECOPDs. Eighty-six percent of patients initiated MITT with two inhalers and 14% with three inhalers.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study investigating the baseline characteristics of new initiators of multiple-inhaler triple therapy (MITT) in the United Kingdom (UK) found that just over half of patients initiated triple therapy following ICS/LABA therapy, and approximately one third following LAMA monotherapy. 3 Of the new MITT initiators, 41% had a recorded forced expiratory volume in 1 second (FEV 1 ) <50% and 58% had at least one moderate/severe acute exacerbation of COPD (AECOPD) in the 12 months prior to MITT initiation.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of New Users of Single- and Multiple-Inhaler Triple Therapy for COPD in Primary Care in England

Rothnie¹,

Joksaite²,

Sansbury³

et al. 2022

COPD

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Purpose Inhaled triple therapy is recommended for patients with chronic obstructive pulmonary disease (COPD) who have poorly controlled symptoms and to reduce the risk of exacerbations. This study assessed the clinical characteristics of new users of single- and multiple-inhaler triple therapy (SITT and MITT) treated in a primary care setting in England. Patients and Methods This cross-sectional, observational study used data from an electronic health record database (CPRD Aurum) of COPD patients registered with a primary care practice in England, with linkage to a secondary care database. Patients were required to have initiated a new triple therapy (index) between November 2017 and November 2018 and have ≥12 months of available medical history prior to the index date. Results In total, 3536 patients initiated fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) SITT for the first time: 65% had a Medical Research Council (MRC) dyspnea score ≥3, 45% had forced expiratory volume in 1 second (FEV 1 )% predicted <50%, and 64% had a moderate or severe exacerbation in the previous 12 months. The majority (83%) of new FF/UMEC/VI users had a history of MITT use. Immediately prior to FF/UMEC/VI initiation, 46% received MITT, 25% received an inhaled corticosteroid (ICS)/long-acting β 2 -agonist (LABA), 12% received long-acting muscarinic antagonist (LAMA)/LABA, and 14% stepped up directly from LAMA monotherapy. A second cohort of 6540 patients initiated triple therapy (SITT or MITT) for the first time. COPD severity (airflow limitation, exacerbation history) was worse among patients initiating SITT versus MITT. In the 12 months before triple-therapy initiation, ICS/LABA was the most common treatment; a step up from LAMA/LABA was more common among patients initiating FF/UMEC/VI (34%) or beclomethasone/formoterol/glycopyrronium bromide SITT (25%) than MITT (14%). Conclusion First-time triple therapy was frequently initiated in patients with COPD inadequately controlled on maintenance therapy. General practitioners in England generally identify appropriate patients who require initiation of triple therapy.

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“…The effectiveness of treatment evaluated in real-world studies can complement traditional RCTs by providing a comprehensive overview of treatments in routine clinical practice. Previous real-world studies usually selected one or two types of bronchodilators in mono, dual combination or triple combinations for analysis ( Kalhan et al, 2021 ; Sansbury et al, 2021 ; Xu et al, 2021 ), and some studies have compared the effect between open triple and closed triple therapy ( Ferguson et al, 2020 ; Huang et al, 2021 ). However, there is a lack of real-world data on the effects of the inhalation therapies including mono, dual combination and triple combination therapies among patients with symptomatic COPD in China.…”

Section: Introductionmentioning

confidence: 99%

Real-World Effectiveness of Inhalation Therapy Among Patients With Symptomatic COPD in China: A Multicenter Prospective Study

et al. 2021

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Purpose: This real-world study evaluated the effectiveness of different inhalation therapies in patients with symptomatic chronic obstructive pulmonary disease (COPD) in China and also explored the relevant factors that influence the effectiveness of inhalation therapy.Patients and Methods: We conducted a multicenter prospective longitudinal study that was carried out in 12 hospitals in China from December 2016 to June 2021. A face-to-face interview was conducted to collect data. Baseline data were collected at the first visit. Minimum clinically important difference (MCID) was defined as attaining a COPD assessment test (CAT) decrease ≥2. We mainly assessed the MCID and the incidence of exacerbations at the 6 months follow-up.Results: In 695 patients, the mean age was 62.5 ± 8.2 years, with a mean CAT score of 15.1 ± 6.0. Overall, 341 (49.1%) patients attained the MCID of CAT and the incidence of exacerbation during follow-up was 22.3%. Females were significantly more likely to attain MCID than male in COPD patients (adjusted odd ratio (aOR) = 1.93, adjusted 95% confidence interval (a95%CI) = 1.09–3.42, p = 0.024). Patients treated with LABA/LAMA or ICS/LABA/LAMA (ICS, inhaled corticosteroid; LABA, long-acting β2-agonist; LAMA, long-acting muscarinic antagonist) were more likely to attain MCID than patients treated with LAMA (aOR = 3.97, a95%CI = 2.48–6.35, p < 0.001; aOR = 3.17, a95%CI = 2.09–4.80, p < 0.001, respectively). Patients treated with LABA/LAMA had a higher incidence of severe exacerbation than patients treated with ICS/LABA/LAMA (aOR = 1.95, a95%CI = 1.04–3.66, p = 0.038).Conclusion: The incidence of MCID in symptomatic COPD patients treated with inhalation therapy was nearly 50%. Patients treated with LABA/LAMA or ICS/LABA/LAMA were more likely to attain MCID than patients treated with LAMA. Patients treated with LABA/LAMA had a higher incidence of severe exacerbations than with ICS/LABA/LAMA.

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Real-World Treatment Patterns of Multiple-Inhaler Triple Therapy Among Patients with Chronic Obstructive Pulmonary Disease in UK General Practice

Cited by 11 publications

References 34 publications

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

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

Characteristics of New Users of Single- and Multiple-Inhaler Triple Therapy for COPD in Primary Care in England

Real-World Effectiveness of Inhalation Therapy Among Patients With Symptomatic COPD in China: A Multicenter Prospective Study

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