Umeclidinium/Vilanterol Compared with Fluticasone Propionate/Salmeterol, Budesonide/Formoterol, and Tiotropium as Initial Maintenance Therapy in Patients with COPD Who Have High Costs and Comorbidities

Kalhan, Ravi; Slade, David; Ray, Riju; Moretz, Chad; Germain, Guillaume; Laliberté, François; Shen, Qin; Duh, Mei Sheng; MacKnight, Sean D.; Hahn, Beth

doi:10.2147/copd.s298032

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Clinical respiratory medicine considers bronchial asthma to be one of the most common pathological forms, mostly caused by the heterogeneity of the body's cells [ 1 ]. A cascade of factors is accountable including physiology and environment [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Fluticasone and Salmeterol Dry Powder in Treating Patients with Bronchial Asthma and Its Effect on Inflammatory Factors and Pulmonary Function

Zhang

Liu

Mao

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the efficacy of fluticasone and salmeterol dry powder in treating patients with bronchial asthma and its effects on inflammatory factors and pulmonary function. Methods. One hundred patients with bronchial asthma, admitted to our hospital between April 2019 and June 2020, were enrolled and assigned into two groups using the random number table method. The observation group (n = 50) received budesonide powder, and the experimental group received fluticasone and salmeterol dry powder. The two groups were compared with regard to clinical efficacy, inflammatory factors, pulmonary function, and adverse reactions. Results. In the experimental group, the total effective rate of treatment was significantly higher than that in the observation group ( P < 0.05 ); after treatment, the levels of inflammatory factors in the experimental group were lower than those in the observation group ( P < 0.05 ); after treatment, lung function in the experimental group was significantly higher than that in the observation group ( P < 0.05 ); the incidence of adverse reactions in the experimental group was significantly lower than that in the observation group ( P < 0.05 ). Conclusion. Salmeterol and fluticasone powder has shown impressive clinical benefits in the treatment of bronchial asthma patients. It might be a viable approach to reduce inflammatory factors and improve pulmonary function. Moreover, its good clinical safety profile makes it a promising treatment that ought to be promoted and used widely.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Fluticasone and Salmeterol Dry Powder in Treating Patients with Bronchial Asthma and Its Effect on Inflammatory Factors and Pulmonary Function

Zhang

Liu

Mao

2022

Evidence-Based Complementary and Alternative Medicine

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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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“… 19 In contrast with our findings, a recent matched cohort study found significantly reduced risk of severe exacerbation and numerically reduced risk of overall exacerbation in patients indexed on UMEC/VI compared with those indexed on TIO. 20 However, the patient population in that recent study had high costs and comorbidities and did not have Medicaid, which may explain the disparities between the studies.…”

Section: Discussionmentioning

confidence: 93%

Inpatient Admissions and Re-Admissions in Medicare Beneficiaries Initiating Umeclidinium/Vilanterol or Tiotropium Therapy

Bogart,

Leung,

Cyhaniuk

et al. 2024

COPD

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Purpose Patients with chronic obstructive pulmonary disease (COPD) who are hospitalized are more likely to die from their illness and have increased likelihood of re-admission than those who are not. Subsequent re-admissions further increase the burden on healthcare systems. This study compared inpatient admission rates and time-to-first COPD-related inpatient admission among Medicare beneficiaries with COPD indexed on umeclidinium/vilanterol (UMEC/VI) versus tiotropium (TIO). Patients and Methods This retrospective study used the All-Payer Claims Database to investigate hospital admission and re-admission outcomes in Medicare beneficiaries with COPD with an initial pharmacy claim for UMEC/VI or TIO from 1 January 2015 to 28 February 2020. Inpatient admissions, baseline, and follow-up variables were assessed in patients indexed on UMEC/VI and TIO after propensity score matching (PSM), with time-to-first on-treatment COPD-related inpatient admission as the primary endpoint. Re-admissions were assessed among patients with a COPD-related inpatient admission in the 30- and 90-days post-discharge. Results Post-PSM, 7152 patients indexed on UMEC/VI and 7069 on TIO were eligible for admissions analysis. The mean (standard deviation [SD]) time-to-first COPD-related inpatient admission was 46.71 (87.99) days for patients indexed on UMEC/VI and 44.96 (85.90) days for those on TIO (p=0.06). The mean (SD) number of inpatient admissions per patient was 1.24 (2.92) for patients indexed on UMEC/VI and 1.26 (3.05) for those on TIO (p=0.49). Proportion of patients undergoing re-admissions was similar between treatments over both 30 and 90 days, excluding a significantly lower proportion of patients indexed on UMEC/VI than those indexed on TIO for COPD-related re-admissions for hospital stays of 4–7 days and 7–14 days, and all-cause re-admissions for stays of 4–7 days. Conclusion Patients with COPD using Medicare in the US and receiving UMEC/VI or TIO reported similar time-to-first inpatient admission and similar proportion of re-admissions.

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Umeclidinium/Vilanterol Compared with Fluticasone Propionate/Salmeterol, Budesonide/Formoterol, and Tiotropium as Initial Maintenance Therapy in Patients with COPD Who Have High Costs and Comorbidities

Cited by 7 publications

References 30 publications

Efficacy of Fluticasone and Salmeterol Dry Powder in Treating Patients with Bronchial Asthma and Its Effect on Inflammatory Factors and Pulmonary Function

Efficacy of Fluticasone and Salmeterol Dry Powder in Treating Patients with Bronchial Asthma and Its Effect on Inflammatory Factors and Pulmonary Function

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

Inpatient Admissions and Re-Admissions in Medicare Beneficiaries Initiating Umeclidinium/Vilanterol or Tiotropium Therapy

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