| Popis: |
Douglas Mapel,1 François Laliberté,2 Melissa H Roberts,1,3 Susan R Sama,4 Devi Sundaresan,4 Dominic Pilon,2 Patrick Lefebvre,2 Mei Sheng Duh,5 Jeetvan Patel6 1Health Services Research Division, Lovelace Clinic Foundation, Albuquerque, NM, USA; 2Groupe d’analyse, Montreal, QC, Canada; 3Department of Pharmacy Practice and Administrative Sciences, University of New Mexico, College of Pharmacy, University of New Mexico, Albuquerque, NM, 4Research Department, Reliant Medical Group, Worcester, MA, 5Analysis Group, Boston, MA, 6US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA Introduction: An incremental approach using open-triple therapy may improve outcomes in patients with chronic obstructive pulmonary disease (COPD). However, there is little sufficient, real-world evidence available identifying time to open-triple initiation.Methods: This retrospective study of patients with COPD, newly initiated on long-acting muscarinic antagonist (LAMA) monotherapy or inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combination therapy, assessed baseline demographics, clinical characteristics, and exacerbations during 12 months prior to first LAMA or ICS/LABA use. Time to initiation of open-triple therapy was assessed for 12 months post-index date. Post hoc analyses were performed to assess the subsets of patients with pulmonary-function test (PFT) information and patients with and without comorbid asthma.Results: Demographics and clinical characteristics were similar between cohorts in the prespecified and post hoc analyses. In total, 283 (19.3%) and 160 (10.9%) patients had moderate and severe exacerbations at baseline, respectively, in the LAMA cohort, compared with 482 (21.3%) and 289 (12.8%) patients in the ICS/LABA cohort. Significantly more patients initiated open-triple therapy in the LAMA cohort compared with the ICS/LABA cohort (226 [15.4%] versus 174 [7.7%]; P |
