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
Purpose: Routinely collected healthcare data on the comparative effectiveness of the long-acting muscarinic antagonist/long-acting β2-agonist combination umeclidinium/vilanterol (UMEC/VI) versus tiotropium bromide/olodaterol (TIO/OLO) for chronic obstructive pulmonary disease (COPD) is limited. This...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2023
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| In: |
The International journal of chronic obstructive pulmonary disease
Year: 2023, Volume: 18, Pages: 1431-1444 |
| ISSN: | 1178-2005 |
| DOI: | 10.2147/COPD.S411437 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.2147/COPD.S411437 Verlag, kostenfrei, Volltext: https://www.dovepress.com/comparison-of-rescue-medication-prescriptions-in-patients-with-chronic-peer-reviewed-fulltext-article-COPD 
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| Author Notes: | Gema Requena, Alexandrosz Czira, Victoria Banks, Robert Wood, Theo Tritton, Catherine M. Castillo, Jie Yeap, Rosie Wild, Chris Compton, Kieran J. Rothnie, Felix Herth, Jennifer K. Quint, Afisi S. Ismaila |
| Summary: | Purpose: Routinely collected healthcare data on the comparative effectiveness of the long-acting muscarinic antagonist/long-acting β2-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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| Item Description: | Veröffentlicht: 13. Juli 2023 Gesehen am 22.08.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1178-2005 |
| DOI: | 10.2147/COPD.S411437 |