Comparative Effectiveness of Umeclidinium/Vilanterol versus Indacaterol/Glycopyrronium on Moderate-to-Severe Exacerbations in Patients with Chronic Obstructive Pulmonary Disease in Clinical Practice in England

被引:0
作者
Requena, Gema [1 ,8 ]
Czira, Alexandrosz [1 ]
Banks, Victoria [2 ]
Wood, Robert [2 ]
Tritton, Theo [2 ]
Castillo, Catherine [2 ]
Yeap, Jie [2 ]
Wild, Rosie [2 ]
Compton, Chris [1 ]
Rothnie, Kieran J. [1 ]
Herth, Felix J. F. [3 ,4 ]
Quint, Jennifer K. [5 ]
Ismaila, Afisi S. [6 ,7 ]
机构
[1] GSK, R&D Global Med, Brentford, Middx, England
[2] Adelphi Real World, Real World Evidence, Bollington, Cheshire, England
[3] Heidelberg Univ, Dept Pneumol & Crit Care Med, Heidelberg, Germany
[4] Translat Lung Res Ctr Heidelberg, Heidelberg, Germany
[5] Imperial Coll London, Natl Heart & Lung Inst, London, England
[6] Value Evidence & Outcomes, GSK, Collegeville, PA USA
[7] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
[8] GSK, Epidemiol, Value Evidence & Outcomes, R&D Global Med, Brentford, England
关键词
COPD dual therapy; LABA/LAMA new users; healthcare resource utilization; exacerbations; comparative effectiveness; single-inhaler dual therapy; COPD;
D O I
10.2147/COPD.S408688
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Purpose: Chronic obstructive pulmonary disease (COPD) exacerbations are associated with significant morbidity and mortality and increased economic healthcare burden for patients with COPD. Long-acting muscarinic antagonist (LAMA)/long-acting beta(2)-agonist (LABA) dual therapy is recommended for patients receiving mono-bronchodilator therapy who experience exacerbations or ongoing breathlessness. This study compared two single-inhaler LAMA/LABA dual therapies, umeclidinium/vilanterol (UMEC/VI) and indacaterol/glycopyrronium (IND/GLY), on moderate-to-severe exacerbation rates in patients with COPD in England.Patients and Methods: This retrospective cohort study used linked primary care electronic health record data (Clinical Practice Research Datalink-Aurum) and secondary care data (Hospital Episode Statistics) to assess outcomes for patients with COPD who had a first prescription for single-inhaler UMEC/VI or IND/GLY (index date) between 1 January 2015 and 30 September 2019 (indexing period). Analyses compared UMEC/VI and IND/GLY on moderate-to-severe, moderate, and severe exacerbations, healthcare resource utilization (HCRU), and direct costs at 6, 12, 18, and 24 months, and time-to-first on-treatment exacerbation up to 24 months post-index date. Following inverse probability of treatment weighting (IPTW), non-inferiority and superiority of UMEC/VI versus IND/GLY were assessed.Results: In total, 12,031 patients were included, of whom 8753 (72.8%) were prescribed UMEC/VI and 3278 (27.2%) IND/GLY. After IPTW, for moderate-to-severe exacerbations, weighted rate ratios were <1 at 6, 12, and 18 months and equal to 1 at 24 months for UMEC/VI; around the null value for moderate exacerbations and <1 at all timepoints for severe exacerbations. UMEC/VI showed lower HCRU incidence rates than IND/GLY for all-cause Accident and Emergency visits and COPD-related inpatient stays and associated all-cause costs at 6 months post-indexing. Time-to-triple therapy was similar for both treatments.Conclusion: UMEC/VI demonstrated non-inferiority to IND/GLY in moderate-to-severe exacerbation reduction at 6, 12 and 18 months. These results support previous findings demonstrating similarity between UMEC/VI and IND/GLY on reduction of moderate-to-severe exacerbations.
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收藏
页码:2039 / 2054
页数:16
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