| アブストラクト | PURPOSE: Routinely collected healthcare data on the comparative effectiveness of the long-acting muscarinic antagonist/long-acting beta(2)-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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| ジャーナル名 | International journal of chronic obstructive pulmonary disease |
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| Pubmed追加日 | 2023/7/19 |
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| 投稿者 | Requena, Gema; Czira, Alexandrosz; Banks, Victoria; Wood, Robert; Tritton, Theo; Castillo, Catherine M; Yeap, Jie; Wild, Rosie; Compton, Chris; Rothnie, Kieran J; Herth, Felix; Quint, Jennifer K; Ismaila, Afisi S |
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| 組織名 | GSK, R&D Global Medical, Brentford, Middlesex, UK.;Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK.;Department of Pulmonology and Respiratory Care Medicine, Thoraxklinik at the;University of Heidelberg, Heidelberg, Germany.;Translational Lung Research Center Heidelberg, Member of the German Center for;Lung Research DZL, Heidelberg, Germany.;National Heart and Lung Institute, Imperial College London, London, UK.;Value Evidence and Outcomes, GSK, Collegeville, PA, USA.;Department of Health Research Methods, Evidence and Impact, McMaster University,;Hamilton, ON, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37465818/ |
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