Journal Article

Characteristics of Users and New Initiators of Single- and Multiple-Inhaler Triple Therapy for Chronic Obstructive Pulmonary Disease in Germany

Ismaila, Afisi, Claussen, Jing, Knapp, Rachel, Beeh, Kai-Michael, Czira, Alexandrosz, Hardtstock, Fränce, Rothnie, Kieran J, Wilke, Thomas, Compton, Chris

2024

Overview

To assess patient characteristics of users and new initiators of triple therapy for chronic obstructive pulmonary disease (COPD) in Germany. Retrospective cohort study of patients with COPD and ≥1 prescription for single-inhaler triple therapy (SITT; fluticasone furoate/umeclidinium/vilanterol [FF/UMEC/VI] or beclomethasone dipropionate/glycopyrronium bromide/formoterol [BDP/GLY/FOR]) or multiple-inhaler triple therapy (MITT), using data from the AOK PLUS German sickness fund (1 January 2015-31 December 2019). The index date was the first date of prescription for FF/UMEC/VI or BDP/GLY/FOR (SITT users), or the first date of overlap of inhaled corticosteroid, long-acting β -agonist, and long-acting muscarinic antagonist (MITT users). Two cohorts were defined: the prevalent cohort included all identified triple therapy users; the incident cohort included patients newly initiating triple therapy for the first time (no prior use of MITT or SITT in the last 2 years). Patient characteristics and treatment patterns were assessed on the index date and during the 24-month pre-index period. In total, 18,630 patients were identified as prevalent triple therapy users (MITT: 17,945; FF/UMEC/VI: 700; BDP/GLY/FOR: 908; non-mutually exclusive) and 2932 patients were identified as incident triple therapy initiators (MITT: 2246; FF/UMEC/VI: 311; BDP/GLY/FOR: 395; non-mutually exclusive). For both the prevalent and incident cohorts, more than two-thirds of patients experienced ≥1 moderate/severe exacerbation in the preceding 24 months; in both cohorts more BDP/GLY/FOR users experienced ≥1 moderate/severe exacerbation, compared with FF/UMEC/VI and MITT users. Overall, 97.9% of prevalent triple therapy users and 86.4% of incident triple therapy initiators received maintenance treatment in the 24-month pre-index period. In a real-world setting in Germany, triple therapy was most frequently used after maintenance therapy in patients with recent exacerbations, in line with current treatment recommendations.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove,Dove Medical Press
• Subject: Administration, Inhalation / Adrenergic beta-2 Receptor Agonists - administration & dosage / Adrenergic beta-2 Receptor Agonists - adverse effects / Aged / Aged, 80 and over / Beclomethasone - administration & dosage / Beclomethasone - adverse effects / Benzyl Alcohols - administration & dosage / Benzyl Alcohols - adverse effects / Bronchodilator Agents - administration & dosage / Bronchodilator Agents - adverse effects / Care and treatment / Chlorobenzenes - administration & dosage / Chlorobenzenes - adverse effects / Chronic obstructive pulmonary disease / Clinical medicine / Codes / Cohort analysis / COPD / Corticosteroids / Datasets / Demographics / Drug Combinations / Drug dosages / Drug Therapy, Combination / Female / Formoterol Fumarate - administration & dosage / Germany / Glycopyrrolate - administration & dosage / Glycopyrrolate - adverse effects / Health insurance / Humans / Inhalers / Lung diseases, Obstructive / Male / Medical research / Medicine, Experimental / Middle Aged / MITT / Muscarinic Antagonists - administration & dosage / Muscarinic Antagonists - adverse effects / Nebulizers and Vaporizers / Observational studies / Original Research / patient characteristics / Patient compliance / Patients / Population / Prescriptions / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - drug therapy / Pulmonary Disease, Chronic Obstructive - physiopathology / Quinuclidines - administration & dosage / Quinuclidines - adverse effects / real-world treatment / Respiratory agents / Retrospective Studies / Sensitivity analysis / SITT / Time Factors / Treatment Outcome